Online ISSN: 2515-8260

Keywords : Nalbuphine


MONITORED ANAESTHESIA CARE–STUDY OF COMPARISON OF NALBUPHINE AND DEXMEDETOMIDINE FOR SEDATION IN MINOR PROCEDURES

Dr. PratikshaChitta, Dr.MrunaliniAlugolu, Dr Ramakrishna Shatagopam, Dr Bhanu Lakshmi, Dr Rekha Kone

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 3, Pages 5971-5981

Aim: The purpose of this study is to analyze and compare the properties of
Dexmedetomidine with that of Nalbuphine regarding duration of sedation, recovery and
adverse effects in short surgical procedures.
Materials and methods: It is observational clinical study involving 60 patients belonging to
ASA grade 1 & 2 posted for elective minor surgical procedures lasting about 45 -60 minutes,
comparison between Dexmedetomidine and Nalbuphine was done and the onset of sedation,
duration of sedation and recovery from sedation including adverse effects of both drugs,
hemodynamic and respiratory parameters were evaluated. Patients were randomly divided
into 2 groups of 30 each .Group N( Nalbuphine) received 50 mcg /kg of Nalbuphine and
Group D(Dexmedetomidine) received 1 mcg/kg of Dexmedetomidine over 10 minutes .
Results: Demographic parameters in both groups were comparable (p>0.05).Nalbuphine and
Dexmedetomidine has comparable onset of time for sedation, duration of sedation and
recovery from the sedation. Onset of sedation is fast in Dexmedetomidine; total duration of
sedation is more with dexmedetomidine and has provided good sedation during the surgical
procedure. As reported in several studies dexmedetomidine offered good cardiovascular
stability without the risk of hypotension . No significant side effects were noted with
dexmedetomidine when compared with Nalbuphine.
Conclusions:Dexmedetomidine when used as a peri operative sedative agent has faster onset
of sedation ,longer duration of sedation ,and the recovery from sedation

A prospective randomised comparative study of intrathecal nalbuphine versus intrathecal fentanyl as adjuvant to 0.5% hyperbaric bupivacaine for arthroscopic knee surgeries under subarachnoid block

Dr. M Sreya Santhoshi and Dr. Vishwa Saineer

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 2, Pages 2091-2099

Background: Subarachnoid (spinal) block is a safe and effective alternative to general anesthesia for arthroscopic knee surgeries. Hyperbaric bupivacaine, the local anaesthetic most commonly used, don’t have the advantage of prolonged analgesia. Due to the early arising post-operative pain the role of various adjuvants has been proposed and evaluated. The present study was aimed to compare the clinical efficiency of intrathecal fentanyl with nalbuphine as adjuvant to 0.5% hyperbaric bupivacaine for arthroscopic knee surgeries. Patients and Methods: A total of 68 patients were randomly taken for this study and categorized into Group Ⅰ (nalbuphine) and Group II (fentanyl). Each group received 12.5mg of 0.5% heavy bupivacaine with 1 mg nalbuphine or 25μg fentanyl diluting it to 3 ml total volume. Sensory and motor block characteristics and time to first rescue analgesia were recorded as the primary end points. Drug‑related side effects of hypotension, bradycardia, respiratory depression, nausea, vomiting, shivering, urinary retention and pruritus were recorded as the secondary outcomes.
Results: Sensory and motor blockade and time for peak sensory level was earlier in group I as compared to group II. Mean time for 2 segments regression in Group I was prolonged as compared to group Ⅱ. Duration of motor block in Group I [241.471± 12.464 min]was significantly prolonged compared to Group II [179.265± 6.868 min] with (p=0.000). Sensory level at L4 in Group I was 406.618± 17.953 min and in Group II was 228.235± 8.694 min with (p=0.000). Rescue analgesia time in Group I [401.471±16.946 min] was significantly prolonged as compared to Group II [220.000±11.282 min] with (p=0.000). The adverse events in group I are lesser as compared to group II and was statistically significant.
Conclusion: Nalbuphine is a better adjuvant than fentanyl in spinal anesthesia for prolonging post-operative analgesia.

A comparative study on fentanyl, morphine and nalbuphine in attenuating stress response and serum cortisol levels during endotracheal intubation

Henin Mohan, Sharan Rajkumar V, Vinodh Mani, Bharath S

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 2, Pages 2585-2595

Background: The process of Laryngoscopy & Intubation is a noxious stimulus, therefore constituting a period of intense sympathetic activity. Various non-pharmacological & pharmacological methods have been used to attenuate this hemodynamic response. Opioids are potent agents that can attenuate pressor response by maintaining the proper depth of anaesthesia. Although there are few studies comparing opioids in attenuating hemodynamic response during intubation, none of them incorporated measuring serum cortisol levels during intubation. Henceforth, in our study, we have compared the efficacy of bolus administration of intravenous (IV) fentanyl, IV morphine and IV nalbuphine to suppress the pressor response and serum cortisol level during laryngoscopy and endotracheal intubation.
Objectives:
1) To evaluate the efficacy of Intravenous (IV) opioids in attenuating the stress response and serum cortisol levels during endotracheal intubation.
Materials and Methods: In our study, 60 ASA I and II patients, aged between 20 to 60 years were enrolled and randomly divided into three groups. Of the three groups group I (received Fentanyl 2 mcg/kg), group II (Received Morphine 0.1mg/kg), and group III (received Nalbuphine 0.2mg/kg). Patients who are pregnant, lactating or illicitly abusing centrally acting drugs, or allergic to the drug under study are excluded from the study After random group allocation hemodynamic parameters like heart rate, blood pressure, and mean arterial pressure were monitored at baseline followed by a 1-minute interval up to 4 minutes after intubation. Furthermore, Blood sampling was done in the preoperative ward followed by a 5- and 10-minutes period after intubation intraoperatively for measuring serum cortisol levels. Conclusion: Comparatively, fentanyl caused a significant reduction in stress response during laryngoscopy and intubation followed by morphine and nalbuphine.