A comparative study on the effect of intrathecal nalbuphine and buprenorphine as an adjuvant to 0.5% hyperbaric bupivacaine in elective infraumbilical surgeries

Abstract

: Subarachnoid blockade provides excellent operating conditions for lower abdominal, orthopedic, pelvic, urological, gynecological and lower extremity surgery. Most subarachnoid anesthetics are single shot injections and have a definite duration; hence opioids have been used along with local anesthetics in subarachnoid block to prolong its effect, duration, quality of analgesia and minimize the necessity of postoperative analgesics.: The primary objective of the study was to assess the onset and duration of sensory and motor blockade. The secondary objective of the study was to compare the hemodynamics, duration of postoperative analgesia and the complications encountered between the two groups.: A prospective randomized double-blinded study was done in 120 patients divided into two group with 60 in each group as group N and group B by computer generated random numbers. Group N received 0.5% Heavy Bupivacaine (3.2ml) + 0.6mg of Nalbuphine (0.3ml) to a total volume of 3.5 ml and Group B received 0.5% Heavy Bupivacaine (3.2ml) + 90µg of Buprenorphine (0.3 ml) to a total volume of 3.5 ml for spinal anesthesia. The differences between the groups were statistically analyzed with the Independent t test for continuous variables and Pearson’s chi-square test for categorical variables. Observations and results: The onset of sensory block (p=0.303) and motor block (p=0.510) was observed to be faster in group N when compared to group B with statistical insignificance, but the duration of both sensory block (p˂0.001) and motor block (p˂0.001) was more pronounced in group B when compared to group N with statistical significance. The duration of effective analgesia was more pronounced in group B (468.35±30.57 minutes) compared to group N (362.70±35.53 minutes).: The duration of the sensory and motor block with effective postoperative analgesia were more pronounced in buprenorphine compared to nalbuphine and hence intrathecal buprenorphine is a better alternative adjuvant to intrathecal nalbuphine in elective infraumbilical surgeries.