Abstract

This study aimed to compare efficacy of nalbuphine and fentanyl as adjuvant to bupivacaine in providing intra-operative anesthesia and post-operative analgesia in lower limb orthopedic surgeries, and to compare the characteristic of sensory and motor block, hemodynamic parameter, time of first rescue analgesia and adverse effects between two groups.
Method- In this clinical trial, 120 patients undergoing elective lower limb orthopedic surgeries under spinal anesthesia were randomly allocated in two groups. In group BN, the patients received 0.5% 3ml (Heavy Bupivacaine + 800 mcg Nalbuphine. In group BF patients received 0.5% 3ml (Heavy Bupivacaine + 25mcg Fentanyl.
Result & interpretation- In group BF Onset of motor block, maximum level of block and time to reach a peak level of the block was significantly faster, whereas in BN group duration of motor block and time for first rescue analgesia was significantly prolonged. However, there was no significant difference in time for two segment regression=0.157 (NS) and hemodynamic changes.
Conclusion- We conclude that fentanyl as an adjuvant to bupivacaine provides higher segmental level sensory blockage, faster sensory and motor blockage than nalbuphine. Postoperative analgesia more in the Nalbuphine group than fentanyl.