Comparison of Intrathecal Dexmedetomidine and Nalbuphine as an Adjuvant in Hyperbaric Bupivacaine for Saddle Block and Postoperative Analgesia in Patients Undergoing Perianal Surgeries

Gantasala, Bhargav Vishnu; Singam, Amol; Rallabhandi, Saranya; Chaubey, Kashish; Deulkar, Pallavi; Bansal, Ayush Pal

doi:10.14260/jemds/2020/442

Cited by 2 publications

(2 citation statements)

References 18 publications

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“…Other related [7][8][9][10][11][12] studies on bupivacaine and dexmedetomidine were reviewed Akca et al concluded that no adverse effects was seen on the cartilage of rat knees when dexmedetomidine was used. However, they did not comment on its action on humans.…”

Section: Discussionmentioning

confidence: 99%

A Comparative Evaluation of Intra-Articular Bupivacaine vs Bupivacaine and Dexmedetomidine for Postoperative Analgesia in Arthroscopic Knee Surgeries: A Study Protocol

Francis

Modak

2021

JPRI

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Background: Various degrees of pain is seen in the post-operative period following almost every arthroscopic knee surgery. The reason behind this pain is due to the irritation that occurs to the nerve endings that are found free in the synovium of the knee. Hence, to make this difficult period pain free various analgesics are given to the patient. They are given through various routes and they may be given as sole analgesics or in combination. One such routes used is the intra-articular route in which analgesics are given intra-articularly for post -operative analgesia. Dexmedetomidine is a drug which can be used the aforementioned route. The main of this study is to evaluate the effectiveness of Intra-articular Dexmedetomidine as an adjuvant to Intra-articular Bupivacaine. Aim: This study aims to compare Intra-articular Bupivacaine vs Bupivacaine and Dexmedetomidine for prolonging post-operative analgesia following knee arthroscopy surgery. Objectives: The primary objective is to assess the duration of postoperative analgesia produced by Dexmedetomidine when used as an adjuvant to Intra-articular Bupivacaine after arthroscopic knee surgeries. The secondary objectives are to evaluate Dexmedetomidine as an adjuvant to Intra-articular Bupivacaine, with respect to: Quality of analgesia, Number of doses of rescue analgesic required during study period, Systemic/Local side effects. Methods: 60 patients within the age group 20-60 undergoing arthroscopic knee surgeries will be enrolled for the study. Following the completion of surgery, patients allotted to Group B will receive 19ml of Intra-articular Bupivacaine with 1ml of normal saline and patients allotted to Group D will receive 19 ml of Intra-articular Bupivacaine with 1mcg/kg Dexmedetomidine. Post-operative analgesia will be monitored using VAS and the requirement of rescue analgesics in both groups will be noted down and compared. Expected Outcomes: The VAS and total requirement of rescue analgesics is expected to be less in Group D with minimal/no side effects.

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Section: Discussionmentioning

confidence: 99%

A Comparative Evaluation of Intra-Articular Bupivacaine vs Bupivacaine and Dexmedetomidine for Postoperative Analgesia in Arthroscopic Knee Surgeries: A Study Protocol

Francis

Modak

2021

JPRI

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“…They found that 12.5% injectable bupivacaine heavy with 0.8 mg 0.5 ml nalbuphine was the most effective of the three groups [45]. Studies on post-operative analgesic efficacy of nalbuphine were reported by Dalal et al [46] and Gantasala et al [47].…”

Section: Hussain Et Al Compared the Mean Intake Of Commensurable Dosa...mentioning

confidence: 99%

Pharmacological Features, Therapeutic Efficacy and Side Effects of Nalbuphine: A Review

Shiras

Ninave

2021

JPRI

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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.

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Comparison of Intrathecal Dexmedetomidine and Nalbuphine as an Adjuvant in Hyperbaric Bupivacaine for Saddle Block and Postoperative Analgesia in Patients Undergoing Perianal Surgeries

Cited by 2 publications

References 18 publications

A Comparative Evaluation of Intra-Articular Bupivacaine vs Bupivacaine and Dexmedetomidine for Postoperative Analgesia in Arthroscopic Knee Surgeries: A Study Protocol

A Comparative Evaluation of Intra-Articular Bupivacaine vs Bupivacaine and Dexmedetomidine for Postoperative Analgesia in Arthroscopic Knee Surgeries: A Study Protocol

Pharmacological Features, Therapeutic Efficacy and Side Effects of Nalbuphine: A Review

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