A Comparative Study of Epidural 0.5%Bupivacaine with Nalbuphine And 0.5% Bupivacaine with Fentanyl in Lower Abdominal and Lowerlimb Surgeries

Abstract

Background: Epidural opioids have unique advantages over conventional, intermittent IV/ IM administration, in that patients given epidural opioids have fewer respiratory complications and can be mobilized sooner in the postoperative period. Aim: To compare the effects of epidural 0.5%Bupivacaine with nalbuphine and 0.5%Bupivacaine with fentanyl in lower abdominal and lower limb surgeries. Methods and materials: A randomized, single blinded, clinical study was conducted involving 60 patients belonging to ASA Grade I & II posted for elective infra umbilical surgeries. Patients were randomly divided into 2 groups of 30 each. Group A received 15ml of 0.5% bupivacaine + 1 ml of nalbuphine (10 mg); Group b received 15ml of 0.5% bupivacaine + 1 ml of fentanyl (50g).Results: Demographic parameters in both groups were comparable (p > 0.05). Nalbuphine and fentanyl when used with Bupivacaine has comparable onset of time for sensory blockade and motor blockade. Total duration of sensory blockade is more with Nalbuphine and bupivacaine and has provided excellent analgesia in the immediate intraoperative and postoperative period. It produced postoperative analgesia for a period of 4-7hours. As reported in several studies Nalbuphine offered good cardiovascular stability without the risk of respiratory depression which was noted with fentanyl. No significant side effects were noted with epidural nalbuphine when compared to fentanyl.Conclusion: Epidural Nalbuphine with 0.5%bupivacaine significantly prolongs the total duration of sensory blockade with better postoperative analgesia when compared to Epidural Fentanyl with 0.5%bupivacaine.