Key result
Intrathecal nalbuphine (1mg) added to hyperbaric bupivacaine significantly prolonged the duration of effective post-operative analgesia compared to bupivacaine alone (260 vs 180 minutes, p<0.0001).
Why the study?
Does the addition of intrathecal nalbuphine to bupivacaine improve the duration of post-operative analgesia in patients undergoing lower limb surgeries?
RCT (n=60)
Double-blind
Computerized randomization method
No
Does the addition of intrathecal nalbuphine to bupivacaine improve the duration of post-operative analgesia in patients undergoing lower limb surgeries?
Absolute Event Rate: 260% vs 180%
p-value: p=<0.0001
The addition of 1mg intrathecal nalbuphine to 0.5% hyperbaric bupivacaine significantly prolongs the duration of post-operative analgesia without increasing adverse effects in patients undergoing lower limb surgeries.
Supports intrathecal nalbuphine consideration for extended analgesia in lower limb surgery; extends RCT evidence on spinal adjuvants.
When nalbuphine is added as an adjuvant to intrathecal bupivacaine, it has potential to provide good intraoperative and post operative analgesia with decreased incidence of μ receptor side effectslike respiratory depression [4]. The side effects of nalbuphine are like dizziness, bradycardia, nausea, vomiting, pruritis, urinary retention and sedation. Nalbuphine has short duration of action due to its lipid solubility and rapid clearance when compared to morphine [5].
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Chaithra GV (2017) conducted an RCT in Lower limb surgeries (n=60). Nalbuphine added to hyperbaric bupivacaine vs. 15mg 0.5% hyperbaric bupivacaine + 0.1ml normal saline was evaluated on Duration of effective analgesia (minutes) (p=<0.0001). Intrathecal nalbuphine (1mg) added to hyperbaric bupivacaine significantly prolonged the duration of effective post-operative analgesia compared to bupivacaine alone (260 vs 180 minutes, p<0.0001).
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