A comparative study of three different doses of nalbuphine as an adjuvant to intrathecal bupivacaine for postoperative analgesia in abdominal hysterectomy

Ahmed, Firoz; Narula, Hunny; Khandelwal, Mamta; Dutta, Debojyoti

doi:10.4103/0970-5333.173457

Cited by 16 publications

(8 citation statements)

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“…The same result reported by Tiwari et al [18] but by using smaller dose (0.2 and 0.4 mg) . Supporting the previous results, Ahmed et al [19] concluded that significant increase in postoperative duration of analgesia compared with the vehicle-treated group in abdominal operation following administration of intrathecal nalbuphine in doses of 0.8,1.6 and 2.4 mg .The same results were obtained by both Kumaresan and Raj [20] and Mukherjee et al [21] who used 0.4, 0.8 mg of intrathecally nalbuphine in patients scheduled in optional lower limb surgeries and show significant analgesia prolongation. On the other hand, Verma et al [22] concluded intrathecal nalbuphine 2 mg is effective in enhancing postoperative analgesia compared to bupivacaine alone or along with tramadol.…”

Section: Discussionsupporting

confidence: 84%

Ultrasound Guided Transversus Abdominis Plane Block versus Intrathecal Nalbuphine Injection for Postoperative Analgesia in Preeclamptic Patients Undergoing Cesarean Section

Attia¹,

Abo-Elhussein²,

Mustafa³

2018

JAS

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Section: Discussionsupporting

confidence: 84%

Ultrasound Guided Transversus Abdominis Plane Block versus Intrathecal Nalbuphine Injection for Postoperative Analgesia in Preeclamptic Patients Undergoing Cesarean Section

Attia¹,

Abo-Elhussein²,

Mustafa³

2018

JAS

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“…There are numerous choices of neuraxial additives, such as opioids (morphine, fentanyl, buprenorphine, nalbuphine), N-methyl-d-aspartate antagonists (ketamine), alpha 2 adrenoceptor agonists (clonidine and dexmedetomidine), vasoconstrictors (adrenaline), Gamma-Aminobutyric Acid (GABA) receptor agonists (midazolam), cholinergic agonists (neostigmine), and sodium bicarbonate, but no drug inhibits nociception without its associated side effects. [6] …”

Section: Introductionmentioning

confidence: 99%

Comparison of the effect of adding midazolam versus fentanyl to intrathecal levobupivacaine in patients undergoing cesarean section: double-blind, randomized clinical trial

AbdelRady

Fathy

Abdallah

et al. 2024

Brazilian Journal of Anesthesiology (English Edition)

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“…In addition, it maintains the hemodynamic stability of the patient [ 4 ]. Fentanyl is an opioid receptor agonist that is synthetically prepared and is a type of phenyl piperidine derivative that is extremely potent due to its high lipophilicity [ 5 ]. Because of its rapid onset and narrowed time of action, with minimalistic cephalad spread, its use as an adjuvant to subarachnoid anesthesia is preferred.…”

Section: Introductionmentioning

confidence: 99%

Intrathecal Adjuvant Midazolam Versus Fentanyl With Hyperbaric Bupivacaine for Post-operative Analgesia in Women Undergoing Total Abdominal Hysterectomy

Nayak¹,

Ninave²,

Tayade³

et al. 2023

Cureus

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Background The administration of adequate analgesia post-operatively has been associated with fewer cardiopulmonary complications, lower morbidity and mortality, lower healthcare costs, and higher patient satisfaction. One of the most effective ways to raise the standard of healthcare would be standardization of multimodal analgesia with enhanced recovery after surgery. Adjuncts to spinal anesthetists can achieve a better post-operative pain relief with less doses of rescue analgesia. Methods This was a prospective, randomized trial conducted on 60 women undergoing abdominal hysterectomy under spinal anesthesia. We evaluated the impact of adding 0.5 mL (2.5 mg) of intrathecal midazolam versus 25 mcg of intrathecal fentanyl (0.5 mL) with 2.5 mL injection of 0.5% bupivacaine (hyperbaric) (12.5 mg). The outcomes were prolongation of analgesia in the post-operative period, onset and duration of sensory and motor blockade, stable hemodynamics, and any adverse reactions to the study drugs. Results The two groups, group M (midazolam + hyperbaric bupivacaine) and group F (fentanyl + hyperbaric bupivacaine), had similar distribution for age, weight, and type and duration of surgical procedure. Both groups had stable vital parameters and experienced a similar onset of sensory and motor blockade. Intraoperative modified Ramsay sedation score was better in group M in comparison to group F. However, mean of elapsed time of two-segment regression of sensory block, from T12 to L1 level, and mean time to regression, from Bromage score 3 to 2, were longer in group F. Group F also had a better visual analogue scale (VAS) score in the post-operative period than group M, and group F experienced a longer average post-operative analgesic duration (lasting for 367.73 minutes) as compared to group M (lasting for 254.9 minutes), having a difference that was of statistical significance (p < 0.001). No substantial adverse reactions were seen in either group. Conclusion The duration of post-operative analgesia is significantly prolonged when 25 mcg of adjuvant intrathecal fentanyl is used with 0.5% bupivacaine (hyperbaric) as compared to intrathecal midazolam 0.5 mL (2.5 mg) in women undergoing abdominal hysterectomy under spinal anesthesia. Both fentanyl and midazolam have minimal adverse reactions and are safe to use as adjuvants to 0.5% of bupivacaine (hyperbaric) in surgeries conducted in the lower abdomen.

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A comparative study of three different doses of nalbuphine as an adjuvant to intrathecal bupivacaine for postoperative analgesia in abdominal hysterectomy

Cited by 16 publications

References 1 publication

Ultrasound Guided Transversus Abdominis Plane Block versus Intrathecal Nalbuphine Injection for Postoperative Analgesia in Preeclamptic Patients Undergoing Cesarean Section

Ultrasound Guided Transversus Abdominis Plane Block versus Intrathecal Nalbuphine Injection for Postoperative Analgesia in Preeclamptic Patients Undergoing Cesarean Section

Comparison of the effect of adding midazolam versus fentanyl to intrathecal levobupivacaine in patients undergoing cesarean section: double-blind, randomized clinical trial

Intrathecal Adjuvant Midazolam Versus Fentanyl With Hyperbaric Bupivacaine for Post-operative Analgesia in Women Undergoing Total Abdominal Hysterectomy

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