A Comparison between Intrathecal Nalbuphine versus Fentanyl as an Adjuvant with 0.5% Hyperbaric Bupivacaine for Postoperative Analgesia in Parturients Undergoing Lower Segment Cesarean Section

Journal of Obstetric Anaesthesia and Critical Care

article

Neena Jain¹  Surendra K. Sethi¹  Amrit L. Saini¹  Veena Patodi¹  Kavita Jain¹  BeenaThada¹ 

[1] Department of Anaesthesiology, J. L. N. Medical College and Hospital

关键词: Bupivacaine;    cesarean section;    fentanyl;    nalbuphine;    subarachnoid block;   

DOI  :  10.4103/JOACC.JOACC_67_21

学科分类：社会科学、人文和艺术（综合）

来源: Medknow

【 摘 要 】

Background: Nalbuphine when used as an adjuvant to hyperbaric bupivacaine has improved the quality of perioperative analgesia. Fentanyl is a lipophilic opioid with a rapid onset and does not cause respiratory depression and improves duration of sensory anesthesia without producing significant side effects. The aim of this study was to compare intrathecal nalbuphine and fentanyl as adjuvants to hyperbaric bupivacaine for postoperative analgesia in lower segment cesarean section. Methods: A total of 100 American Society of Anesthesiologists (ASA) Physical Status (PS) I and II parturients were enrolled for lower segment cesarean section. Parturients were randomly allocated into 2 groups - Group F (n = 50) received bupivacaine 0.5% (heavy) 1.6 ml (8 mg) + fentanyl 20 μg (0.4 ml) and Group N (n = 50) received bupivacaine 0.5% (heavy) 1.6 ml (8 mg) + nalbuphine 0.4 mg (0.4 ml) under subarachnoid block (total volume = 2 ml). Time of onset and duration of sensory and motor block, Visual Analog Scale (VAS) score, duration of analgesia, sedation, rescue analgesic consumption, APGAR score, hemodynamic changes and adverse effects were noted. Results: Onset of sensory and motor block were significantly faster in Group F while duration of sensory block was significantly longer in Group N (P < 0.05). Duration of analgesia was also significantly longer in Group N (214.34 ± 9.31 min) compared to Group F (195.00 ± 9.18 min) (P < 0.001). No significant hemodynamic changes and adverse effects were noted in both groups (P 0.05). Conclusion: Both of these drugs can be effectively used as an adjuvant to hyperbaric 0.5% bupivacaine in subarachnoid block for parturients undergoing lower segment cesarean section.

【 授权许可】

CC BY-NC-SA