A COMPARATIVE STUDY OF NALBUPHINE WITH BUTORPHANOL FOR IMMEDIATE POSTOPERATIVE ANALGESIA IN LUMBAR SPINE SURGERIES.

Dr. Tushar Kumar, Dr. Mukesh Kumar, Dr. Prof. Ladhu lakra, Dr. Kundan Kumar, Dr. Reena Hansda, Dr. (Prof) Usha Suwalka

Abstract


Postoperative pain is acute pain and can affect nearly every organ function and may adversely influence postoperative
morbidity and mortality. Pharmacological management with intravenous opioids is a common, effective and a well
known method used to treat this pain. Our study aims at comparing the analgesic efficacy of nalbuphine and butorphanol as opioid analgesics for
post operative pain relief for immediate postoperative period. Material and methods: double blind, randomized controlled clinical trial, 20
patients aged 18 to 60 years, ASA grade 1 or 2, posted for lumber spine surgery surgery under general anaesthesia. Patients were randomly
allocated into 2 groups, Study design: Group N (Nalbuphine) and Group B (Butorphanol). Group N received 0.2 mg/kg of Nalbuphine
hydrochloride whereas group B received 0.04 mg /kg of butorphanol , intravenously prior to induction of anaesthesia. Hemodynamic
parameters, postoperative analgesia, time of rescue analgesia, respiratory depression, sedation scores and side effects were studied. Pain
assessed as VAS. Results: scores were not significantly different to start with (60 mins) immediate postop in both the groups (p= 0.76). They were
lower in both Group B and Group N at 15, 30, 45,60, 75,90 and 105 mins. At 120 mins, there was no significant difference between the mean
VAS across both the groups. No significant differences were seen in recovery from anaesthesia. No significant side effects of nausea, vomiting,
and respiratory depression were noted. Excessive sedation were noted in group B which was significant( p = 0.036). Conclusion: both
butorphanol and nalbuphine provide excellent analgesia in immediate post operative period except that butorphanol causes excessive sedation
specially in elderly age group.


Keywords


Nalbuphine, Butorphanol, Immediate Postoperative Period, Lumbar Spine.

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