A randomized, double blind, control study of the effects of adding nalbuphine to spinal bupivacaine for lower abdominal surgeries in elderly patients

Background and objectives: The purpose of this study was to evaluate the onset, quality and duration of sensory and motor blockade achieved with hyperbaric bupivacaine and nalbuphine combination when administered intrathecally for spinal anesthesia in lower abdominal surgery as well as efficacy of nalbuphine for postoperative analgesia and its side effects if any. Method: 40 ASA I and II patients of age group 50-70 years, scheduled for below umbilicus surgeries were chosen for this study. Patients were randomised in two equal groups of 20 each by lottery method. Group I (Study Group) received 3 ml of hyperbaric bupivacaine 0.5 % + 0.5 ml inj. nalbuphine (0.5 mg) intrathecally. Group II (Control Group) received 3 ml of hyperbaric bupivacaine 0.5 % + 0.5 ml of inj. normal saline intrathecally. Assessment of motor and sensory blockade was done by Bromage scale and pin prick method. Pulse rate, BP, respiratory rate and SpO 2 were monitored. Results: There is no significant difference between 2 groups for onset of motor and sensory blockade but mean time of postoperative analgesia in Study Group was highly significant than Control Group. No patient in our study developed any side effects. Conclusion: Nalbuphine provides better quality of block as compared to bupivacaine alone. It also prolongs postoperative analgesia when used as adjuvant to spinal bupivacaine in elderly patients.