FENTANYL VERSUS NALBUPHINE AS ADJUVANT TO SPINAL BUPIVACAINE FOR CAESAREAN DELIVERY – A COMPARATIVE STUDY

Linthoingambi Samjetsabam, L Kameshwar Singh, Daili Khuo, Sonia Nahakpam, Zarina Wahab, TR Kumara gurubaran, Mutum Sunindini Devi

Abstract


BACKGROUND: Local anaesthetics, commonly bupivacaine has been utilized for providing anaesthesia but alone are usually insufficient to provide uniform block despite the high level of anaesthesia. Several adjuvants have been added to local anaesthetics for prolongation of the duration of single shot spinal anaesthesia e.g. fentanyl, morphine, nalbuphine, etc.

AIM: This study was carried out to see the relative effectiveness of intrathecal fentanyl and intrathecal nalbuphine added to low dose intrathecal bupivacaine given for caesarean delivery.

MATERIALS AND METHODS: A total of 80 patients were randomly allocated to two groups of 40 each. Group A received 1.5 ml of 0.5% hyperbaric bupivacaine + 0.4ml fentanyl(20µg) + 0.1 ml distilled water. Group B received 1.5ml of 0.5 % bupivacaine + 0.4ml nalbuphine(0.8mg) + 0.1 ml distilled water. The groups were studied for assessing the quality of anesthesia and incidence of undesirable complications.

RESULTS: Sensory block characteristics like onset of sensory block is quite fast i.e. 1.85 min for fentanyl group and 1.50 min for nalbuphine group which is comparable, in 22(55%) patients in fentanyl group and 28(70%) patients in nalbuphine group the sensory block height reached T4 level. The fentanyl group has longer duration of analgesia/anaesthesia and motor blockade too is longer with the fentanyl group in comparison to the nalbuphine group. The occurrence of complications was comparable between the two groups.  

CONCLUSION: Both drugs are effective as adjuvant to hyperbaric bupivacaine for spinal anaesthesia for caesarean section providing good quality surgical anaesthesia with practical absence of side effects but fentanyl scores over nalbuphine as far as prolongation of post-operative analgesia is concerned.


Keywords


Fentanyl, Nalbuphine, Adjuvant, Caesarean delivery

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References


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