Satapathy Subhaprada, Nayak Laba K, Behera Sanjaya K, Satapathy Ganesh C, Swain Rasulata, Das Saswati
Anaesthesiology, Kalinga Institute of Medical Sciences, Bhubaneswar, IND.
Cureus. 2023 Jun 30;15(6):e41230. doi: 10.7759/cureus.41230. eCollection 2023 Jun.
Spinal anaesthesia is the most commonly used technique for lower limb orthopaedic surgeries as it is economical and easy to administer. Opioids as adjuvants to local anaesthetics during spinal anaesthesia have played a vital role in reducing post-operative pain qualitatively and effectively.
This prospective randomised study was conducted on 100 patients divided into two groups scheduled for lower limb orthopaedic surgeries. Group bupivacaine fentanyl (BF) received 25 mcg of fentanyl with 15 mg of bupivacaine and Group bupivacaine nalbuphine (BN) received 1 mg of nalbuphine and 15 mg of 0.5% bupivacaine. The aim of the study was to compare the analgesic efficacy of intrathecal fentanyl and nalbuphine as an adjuvant to hyperbaric bupivacaine for spinal anaesthesia. Duration of effective analgesia, haemodynamic parameters, onset and duration of sensory and motor block, adverse effects, and visual analogue scale (VAS) score were assessed.
Duration of effective analgesia was 388±24.88 minutes in the BN group and was higher (p-value <0.001) in comparison to the BF group, which was 304.70±15.76 minutes.
Nalbuphine was more effective than fentanyl in providing post-operative analgesia when used as an adjuvant to hyperbaric bupivacaine.
脊髓麻醉是下肢骨科手术最常用的技术，因为它经济且易于实施。在脊髓麻醉期间，阿片类药物作为局部麻醉剂的佐剂，在定性和有效地减轻术后疼痛方面发挥了至关重要的作用。
本前瞻性随机研究对100例计划进行下肢骨科手术的患者进行，分为两组。布比卡因芬太尼组（BF组）接受25微克芬太尼加15毫克布比卡因，布比卡因纳布啡组（BN组）接受1毫克纳布啡和15毫克0.5%布比卡因。本研究的目的是比较鞘内注射芬太尼和纳布啡作为高压布比卡因脊髓麻醉佐剂的镇痛效果。评估有效镇痛时间、血流动力学参数、感觉和运动阻滞的起效时间和持续时间、不良反应以及视觉模拟评分（VAS）。
BN组的有效镇痛时间为388±24.88分钟，与BF组的304.70±15.76分钟相比更高（p值<0.001）。
当作为高压布比卡因的佐剂使用时，纳布啡在提供术后镇痛方面比芬太尼更有效。
