Comparative study of efficacy of tramadol versus nalbuphine as an adjuvant to intrathecal bupivacaine
Background: Spinal anesthesia is commonly used for infra umbilical surgeries due to its effective analgesia and favorable safety profile. However, local anesthetics like bupivacaine alone provide limited postoperative pain relief. Aim and Objectives: This randomized double-blind study aimed to compa...
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Krishna Vishwa Vidyapeeth (Deemed to be University), Karad
2025-01-01
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| Series: | Journal of Krishna Institute of Medical Sciences University |
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| Online Access: | https://www.jkimsu.com/jkimsu-vol14no1/JKIMSU,%20Vol.%2014,%20No.%201,%20January-March%202025%20Page%20108-115.pdf |
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| author | Sathyasuba Meenakshi Sundaram Srinidhi Narayanan Gayathri Ramesh Raghuraman M Sethuraman Bhagawathi B |
| author_facet | Sathyasuba Meenakshi Sundaram Srinidhi Narayanan Gayathri Ramesh Raghuraman M Sethuraman Bhagawathi B |
| author_sort | Sathyasuba Meenakshi Sundaram |
| collection | DOAJ |
| description | Background: Spinal anesthesia is commonly used for infra umbilical surgeries due to its effective analgesia and favorable safety profile. However, local anesthetics like bupivacaine alone provide limited postoperative pain relief. Aim and Objectives: This randomized double-blind study aimed to compare the duration of analgesia of intrathecal tramadol and nalbuphine added to hyperbaric bupivacaine for infra umbilical surgeries, as there are limited studies on this comparison. Material and Methods: A total of 60 patients scheduled for elective infraumbilical surgeries at a tertiary care center were randomized into two groups. Group T received 25 mg of tramadol, and Group N received 1 mg of nalbuphine, both as adjuvants to 0.5% hyperbaric bupivacaine. The primary outcome was the duration of analgesia. Secondary outcomes included the onset and duration of sensory and motor blocks, hemodynamic stability, time to rescue analgesia and incidence of side effects. Results: Although nalbuphine provided a slightly faster onset of
sensory and motor block (4.0 ± 1.0 and 5.7 ± 1.2 minutes respectively) than tramadol (4.3 ± 1.1 and 6.0 ± 1.3 minutes respectively), it was statistically insignificant (p = 0.238, 0.314). Also, the duration of analgesia was significantly
longer in the nalbuphine group (8.2 ± 1.3 hours) compared to the tramadol group (7.5 ± 1.2 hours) (p = 0.045). Both groups maintained stable hemodynamic profiles, and there was no significant difference in the incidence of side effects. Conclusion: Nalbuphine, when added to intrathecal bupivacaine, provides a longer duration of analgesia with comparable onset times and safety profile. Thus nalbuphine can be considered a more effective adjuvant for enhanced postoperative pain relief. |
| format | Article |
| id | doaj-art-0db70314e35e4a5c9a73fdb0c059cfd0 |
| institution | Kabale University |
| issn | 2231-4261 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | Krishna Vishwa Vidyapeeth (Deemed to be University), Karad |
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| series | Journal of Krishna Institute of Medical Sciences University |
| spelling | doaj-art-0db70314e35e4a5c9a73fdb0c059cfd02025-08-25T11:10:36ZengKrishna Vishwa Vidyapeeth (Deemed to be University), KaradJournal of Krishna Institute of Medical Sciences University2231-42612025-01-01141108115Comparative study of efficacy of tramadol versus nalbuphine as an adjuvant to intrathecal bupivacaineSathyasuba Meenakshi Sundaram0Srinidhi Narayanan1Gayathri Ramesh2Raghuraman M Sethuraman3Bhagawathi B4Department of Anesthesiology, Sree Balaji Medical College & Hospital, BIHER, Chennai - 600044 (Tamilnadu), IndiaDepartment of Anesthesiology, Sree Balaji Medical College & Hospital, BIHER, Chennai - 600044 (Tamilnadu), IndiaDepartment of Anesthesiology, Sree Balaji Medical College & Hospital, BIHER, Chennai - 600044 (Tamilnadu), IndiaDepartment of Anesthesiology, Sree Balaji Medical College & Hospital, BIHER, Chennai - 600044 (Tamilnadu), IndiaDepartment of Anesthesiology, Sree Balaji Medical College & Hospital, BIHER, Chennai - 600044 (Tamilnadu), IndiaBackground: Spinal anesthesia is commonly used for infra umbilical surgeries due to its effective analgesia and favorable safety profile. However, local anesthetics like bupivacaine alone provide limited postoperative pain relief. Aim and Objectives: This randomized double-blind study aimed to compare the duration of analgesia of intrathecal tramadol and nalbuphine added to hyperbaric bupivacaine for infra umbilical surgeries, as there are limited studies on this comparison. Material and Methods: A total of 60 patients scheduled for elective infraumbilical surgeries at a tertiary care center were randomized into two groups. Group T received 25 mg of tramadol, and Group N received 1 mg of nalbuphine, both as adjuvants to 0.5% hyperbaric bupivacaine. The primary outcome was the duration of analgesia. Secondary outcomes included the onset and duration of sensory and motor blocks, hemodynamic stability, time to rescue analgesia and incidence of side effects. Results: Although nalbuphine provided a slightly faster onset of sensory and motor block (4.0 ± 1.0 and 5.7 ± 1.2 minutes respectively) than tramadol (4.3 ± 1.1 and 6.0 ± 1.3 minutes respectively), it was statistically insignificant (p = 0.238, 0.314). Also, the duration of analgesia was significantly longer in the nalbuphine group (8.2 ± 1.3 hours) compared to the tramadol group (7.5 ± 1.2 hours) (p = 0.045). Both groups maintained stable hemodynamic profiles, and there was no significant difference in the incidence of side effects. Conclusion: Nalbuphine, when added to intrathecal bupivacaine, provides a longer duration of analgesia with comparable onset times and safety profile. Thus nalbuphine can be considered a more effective adjuvant for enhanced postoperative pain relief.https://www.jkimsu.com/jkimsu-vol14no1/JKIMSU,%20Vol.%2014,%20No.%201,%20January-March%202025%20Page%20108-115.pdfintrathecal opioidsnalbuphinetramadol |
| spellingShingle | Sathyasuba Meenakshi Sundaram Srinidhi Narayanan Gayathri Ramesh Raghuraman M Sethuraman Bhagawathi B Comparative study of efficacy of tramadol versus nalbuphine as an adjuvant to intrathecal bupivacaine Journal of Krishna Institute of Medical Sciences University intrathecal opioids nalbuphine tramadol |
| title | Comparative study of efficacy of tramadol versus nalbuphine as an adjuvant to intrathecal bupivacaine |
| title_full | Comparative study of efficacy of tramadol versus nalbuphine as an adjuvant to intrathecal bupivacaine |
| title_fullStr | Comparative study of efficacy of tramadol versus nalbuphine as an adjuvant to intrathecal bupivacaine |
| title_full_unstemmed | Comparative study of efficacy of tramadol versus nalbuphine as an adjuvant to intrathecal bupivacaine |
| title_short | Comparative study of efficacy of tramadol versus nalbuphine as an adjuvant to intrathecal bupivacaine |
| title_sort | comparative study of efficacy of tramadol versus nalbuphine as an adjuvant to intrathecal bupivacaine |
| topic | intrathecal opioids nalbuphine tramadol |
| url | https://www.jkimsu.com/jkimsu-vol14no1/JKIMSU,%20Vol.%2014,%20No.%201,%20January-March%202025%20Page%20108-115.pdf |
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