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Comparative Studies | Anaesthesiology | India | Volume 11 Issue 8, August 2022
A Comparative Study of Nalbuphine and Fentanyl as Adjuvant to Thoracic Epidural Ropivacine for Post Operative Analgesia in Laparotomy Surgeries
Dr. (Mrs.) Anita Pareek | Dr. Kiwi Mantan | Dr. Pramila Soni | Dr. Manish Kumar Verma | Dr. Jinesh Baid | Dr. Priyanka Kumari
Abstract: Background: A prospective, double-blind, randomized study was carried out to compare the quality of postoperative analgesia and side-effect profile between epidurally administered fentanyl and nalbuphine as an adjuvant to 0.2% ropivacaine. Postoperative pain therapy for abdominal surgeries is important far beyond the perioperative period because sensitization to painful stimuli can cause postoperative morbidity. Materials and Methods: A total of 60 patients between the age of 18 and 65 years of American Society of Anesthesiologists (ASA) Class I E and II E who underwent laparotomy surgeries were randomly allocated into three groups. Group 1 received 13 ml of 0.2% ropivacaine with 10 mg (1ml) nalbuphine (Total volume 14 ml), Group 2 received 13 ml of 0.2% ropivacaine with 50?g (1ml) fentanyl in epidural catheter (Total volume 14 ml) and Group 3 received 14 ml of 0.2% ropivacaine in thoracic epidural catheter. Quality of analgesia, cardiorespiratory parameters, side-effects, and the need of rescue intravenous analgesia were observed. Results: Mean VAS score was lower in G 1 (0.75?0.91) and it was statistically significant when compared to G 2 (1.35?0.99) and G 3 (1.55?1.05), (p value = 0.035). Thus the requirement of 24 hours rescue analgesic in term of number was lower in G 1(0.50?0.61) when compared to group 2 (0.85?0.67) and group 3 (2.20?0.70), which was statistically significant. (p value = 0.0001). Systolic BP, diastolic BP and mean arterial BP were maintained and comparable in all three groups during first 24 hours of postoperative period (p value > 0.05). Pulse rate was rate was lower and it was statistically significantly in first 15 minutes in group 3 as compared to group 1, group 2. (p value < 0.05) However after that pulse rate was comparable in all three groups during first 24 hours of postoperative period (p value > 0.05). Side effects were comparable in group 1, group 2 and group 3 and were statistically insignificant. (p value > 0.05). Conclusion: Thoracic epidurally administrated ropivacaine with nalbuphine is more effective than ropivacaine with fentanyl for postoperative analgesia up to 24 hours of the postoperative period in laparotomies.
Keywords: fentanyl, emergency laparotomy, nalbuphine, postoperative analgesia, ropivacaine, thoracic epidural
Edition: Volume 11 Issue 8, August 2022,
Pages: 598 - 602