A comparative study on the effect of intrathecal nalbuphine and buprenorphine as an adjuvant to 0.5% hyperbaric bupivacaine in elective infraumbilical surgeries

Niraj  Kumar; Neeraj; Sudama  Prasad; Rakesh  Kumar

doi:10.51168/sjhrafrica.v5i11.1812

Authors

Niraj Kumar Senior Resident, Department of Anaesthesiology, Patna Medical College & Hospital, Patna, Bihar, India
Neeraj Senior Resident, Department of Anaesthesiology, Patna Medical College & Hospital, Patna, Bihar, India
Sudama Prasad Professor & HOD, Department of Anaesthesiology, Patna Medical College & Hospital, Patna, Bihar, India
Rakesh Kumar Assistant Professor, Department of Anesthesia & Critical Care, Patna Medical College & Hospital, Patna, Bihar, India

DOI:

https://doi.org/10.51168/sjhrafrica.v5i11.1812

Keywords:

Intrathecal adjuvant, nalbuphine, buprenorphine, bupivacaine, spinal anaesthesia, infraumbilical surgeries, postoperative analgesia

Abstract

Background

Spinal anesthesia utilizing 0.5% hyperbaric bupivacaine is frequently employed for infraumbilical surgical procedures. Various opioids have been used as intrathecal adjuvants for intraoperative and postoperative analgesia. Opioid agonist-antagonists nalbuphine and buprenorphine offer long-lasting analgesia with minimal respiratory depression. Clinical trials are ongoing to determine their intrathecal supplement efficacy and safety.

Objective: To assess how sensory and motor blockage, postoperative analgesia, and adverse effects are affected by intrathecal nalbuphine and buprenorphine combined with 0.5% hyperbaric bupivacaine in elective infraumbilical operations.

Methods

This 11-month prospective, randomized, double-blind study was carried out at Patna Medical College and Hospital. For elective infraumbilical procedures involving spinal anesthesia, we recruited 100 ASA physical status I and II patients between the ages of 18 and 60. Patients were divided into two groups of 50 at random:
Additionally, Group N received 3 mL of 0.5% hyperbaric bupivacaine and 0.4 mg of nalbuphine.

Group B was given 3 mL of 0.5% hyperbaric bupivacaine and 60 mcg buprenorphine.

Time until the first rescue analgesic, 24-hour analgesic intake, side effects, and the onset and duration of sensory and motor blockage were all evaluated.

Results

Group N experienced faster sensory and motor blockade initiation, while Group B experienced longer analgesia duration. Group B averaged 457 ± 38 minutes until initial analgesic request, while Group N averaged 315 ± 42 minutes (p < 0.05). Group B had slightly more nausea and pruritus, but it did not require aggressive intervention. Both adjuvants maintained perioperative hemodynamic stability.

Conclusion

buprenorphine provides longer postoperative analgesia than nalbuphine when used with 0.5% hyperbaric bupivacaine in elective infraumbilical surgeries. Nalbuphine induces anesthesia faster. Both agents are safe and effective, and the choice depends on analgesia start and duration.

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