Introduction: Opioids can provide effective analgesia and routinely utilized to treat mild severe pain. Problems related with mu- agonist opioids like nausea, emesis, bowel and bladder disturbances, respiratory depression, pruritus and developing tolerance and dependence. This article will review about the utilization of Nalbuphine, which is a mixed opioid agonist- antagonist that FDA has indicated in moderate to severe pain treatment when an opioid drug is essential and alternative treatment methods have failed. The incidence of the common opioid side effects are low in case of Nalbuphine. Non-FDA approved uses of nalbuphine are in labor analgesia, pruritus associated with opioid, opioid-induced urinary retention and respiratory depression. It can be administered with the regularly utilized mu- opioid agonists like morphine, fentanyl etc. as a combination, giving better analgesia along with abating the incidence as well as the severity of side effects caused by mu-agonist. Methodology: This review article was prepared after a thorough study of the literature using data search engines such as ‘Scopus’,’ PubMed’, ‘Web of Science’, and ‘Google Scholar’. This article referred to prior Nalbuphine observational studies and case reports. Review Findings: After learning the pharmacology, uses, contraindications of Nalbuphine and reviewing the previous observational studies and case reports about Nalbuphine, the drug can be used for treating moderate to severe pain when an opioid drug is essential and reserve treatment methods have failed. Nalbuphine finds its use also in labor analgesia. The incidence of the usual side effects due to opioids are low in case of Nalbuphine. It can be administered with the regularly utilized mu- opioid agonists like morphine, fentanyl etc. as a combination , giving better analgesia along with abating the incidence as well as the severity of side effects caused by mu-agonist. Conclusion: Nalbuphine can be utilized for treating moderate to severe pain, as an adjuvant to balanced anesthesia for pre-operative / post-operative pain relief, for labor analgesia and to treat/ reduce the opioid induced side effects.

Aims and Objectives: To compare the duration of post operative analgesia of nalbuphine 0.3 mg/kg IV and butorphanol 0.04 mg/kg IV in patients posted for short surgical procedures under TIVA. Also to observe the sedation score as well as the side effects like nausea, emesis, pruritis, hypotension, respiratory depression. Materials and Methods: By closed envelope technique, sixty female patients of ASA Class I and II aged 20-60 years, who were posted for short gynaecological surgeries under TIVA were randomly allocated into two groups: Group N (nalbuphine) and Group B (butorphanol). Just prior to surgery, Group N patients got IV Nalbuphine 0.3 mg/kg, while Group B patients received IV Butorphanol 0.04 mg/kg. Patients were asked to rate their pain intensity on a VAS scale in the course of the postoperative period, and the duration of postoperative analgesia was compared between the two groups. The Modified Ramsay sedation scale was exercised to assess sedation at the time of pain complaint, and patients were additionally monitored for 24 hours post the surgery for any adverse or side effects. Results: In group N, 63.33% of patients had duration of pain relief ranging 31-50 minutes, with mean duration of analgesia being 46.333 ± 2.061. In group B, 60% of patients had duration of pain relief ranging from 11-30 minutes, with mean duration being 19.167± 1.68 minutes. In group N, 63.33% of patients had score for sedation as 3 and rest (36.67%) had a  score for sedation as 2.       In group B, 80% of patients had a score for  sedation as  2 and rest (20%) had a score for sedation as 1. Conclusion: When compared to IV Butorphanol, intravenous Nalbuphine delivers a more effective post-operative analgesia with better sedation. IV Nalbuphine is recommended for post operative analgesia in patients undergoing short surgical procedures.  Both the drugs did not cause any side effects.