Comparison of Analgesic Efficacy of subarachnoid Bupivacaine, Bupivacaine with Fentanyl and Bupivacaine with Nalbuphine An Intragroup Prospective Observational Study

Abstract

Opioids are added to local anesthetics to extend theduration of spinal analgesia/anaesthesia. The present study was undertaken to compare the analgesic efficacy of subarachnoid hyperbaric bupivacaine 0.5% alone as a control, bupivacaine 0.5% with fentanyl and bupivacaine 0.5% with nalbuphine. Total 150 patients of either sex, ASA grade I and II, between 18 to 60 years and height 150 to 170 cm, posted for elective lower abdominal and lower limb surgeries were enrolled. They were divided into three equal groups. Group B: received 15mg hyperbaric bupivacaine 0.5%(3ml) + 0.5ml normal saline, Group BF: received 15mg hyperbaric bupivacaine 0.5% (3ml) + Inj. Fentanyl 25µg(0.5ml) and Group BN: received 15mg hyperbaric bupivacaine 0.5%(3ml) + Inj. Nalbuphine 500µg(0.5ml). The sensorimotor blockade was significantly faster and prolonged in group BF and BN than group B. Quality of analgesia during the procedure was excellent in 90%, 94% and 94% in group B, BF and BN respectively. The duration of effective analgesia in group B (229.80±43.542min) was significantly shorter in comparison with group BF (359.40±45.955min) and BN (364.20±38.34min), (P= 0.0001). Subarachnoid fentanyl 25µg and nalbuphine 500µg acts as an adjuvant to potentiate local anesthetic bupivacaine with the result that there is prolongation of sensory and motor blockade & extended duration of effective analgesia in early postoperative period, reducing the total consumption of rescue analgesics.