Background: Nalbuphine when used as adjuvant to hyperbaric bupivacaine has improved the quality of perioperative analgesia with fewer side effects. Fentanyl is a lipophilic opioid with a rapid onset following intrathecal injection. It does not cause respiratory depression and improves duration of sensory anesthesia without producing significant side effects.
Aim: This study aims to compare the postoperative analgesia of intrathecal nalbuphine and fentanyl as adjuvants to bupivacaine in cesarean section.
Methodology: A prospective, randomized, double-blind, and comparative study was conducted on 150 parturients of American Society of Anesthesiologists (ASA) physical status I and II of age group 20-45 years with normal coagulation profile undergoing cesarean section under spinal anesthesia. These patients were randomized into three groups with fifty patients in each group. Group I received 2 ml of 0.5% hyperbaric bupivacaine (10 mg) plus 0.4 ml nalbuphine (0.8 mg), Group II received 2 ml of 0.5% hyperbaric bupivacaine (10 mg) plus 0.4 ml fentanyl (20 μg), and Group III received 2 ml of 0.5% hyperbaric bupivacaine (10 mg) plus 0.4 ml of normal saline.
Results: The mean duration of effective analgesia was 259.20 ± 23.23 min in Group I, 232.70 ± 13.15 min in Group II, and 168.28 ± 7.55 min in Group III. The mean number of rescue analgesics required was significantly lower ( < 0.001) in Group I as compared to Group II and III.
Conclusion: Both intrathecal nalbuphine 0.8 mg and fentanyl 20 μg are effective adjuvants to 0.5% hyperbaric bupivacaine in subarachnoid block. However, intrathecal nalbuphine prolongs postoperative analgesia maximally and may be used as an alternative to intrathecal fentanyl in cesarean section.
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http://dx.doi.org/10.4103/aer.AER_41_18 | DOI Listing |
Reg Anesth Pain Med
December 2024
Anesthesiology, Montefiore Medical Center, Bronx, New York, USA
Background: Preservative-free chloroprocaine is a promising spinal anesthetic for ambulatory surgeries, offering a short duration of action and minimal side effects, which promote faster recovery and discharge. Thus, this study aimed to compare chloroprocaine hydrochloride to the widely used bupivacaine as a spinal anesthetic in ambulatory anorectal surgeries. We hypothesized that chloroprocaine will lead to quicker recovery and discharge, supporting its use in the ambulatory surgical setting.
View Article and Find Full Text PDFReg Anesth Pain Med
December 2024
Department of Urology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, South Korea
Background: The effect of anesthesia methods on non-muscle invasive bladder cancer (NMIBC) recurrence post-resection remains uncertain. We aimed to compare the oncological outcomes of spinal anesthesia (SA) and general anesthesia (GA) in patients with NMIBC.
Methods: This prospective randomized controlled trial recruited 287 patients with clinical NMIBC at Seoul National University Hospital from 2018 to 2020.
Pain Physician
December 2024
Department of Anesthesia, Jiaxing University Affiliated Women and Children Hospital, Jiaxing, China.
Background: Visceral pain is common in cesarean sections conducted under combined spinal-epidural anesthesia (CSE). Epidural volume extension (EVE) is a technique for enhancing the effect of intrathecal blocks by inducing epidural fluid boluses in the CSE. Whether EVE that uses different drugs can reduce visceral pain during cesarean sections is rarely studied.
View Article and Find Full Text PDFIn the field of obstetrics, cesarean sections have now become the most prominent procedure for the delivery of newborns. Cesarean sections may be handled with a variety of different anesthetic approaches, of which most focus seems to be on that of spinal forms, due to their rapid and effective action. Dosages of spinal anesthesia formulations differ depending on multiple variables, such as depth of anesthesia, level of analgesia, and desired duration of effects.
View Article and Find Full Text PDFCureus
November 2024
Department of Anaesthesiology, Uttar Pradesh University of Medical Sciences, Etawah, IND.
Background: The subarachnoid block is the predominant and relatively safe approach during lower limb orthopaedic operations. When used as an additive to intrathecal local anaesthetic, both fentanyl and dexmedetomidine can extend the duration of sensory and motor blockade and improve postoperative analgesia.
Objectives: The objective of this study is to assess and compare the efficacy of sequential administration of fentanyl and dexmedetomidine alongside 0.
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