TO COMPARE NALBUPHINE AND BUPRENORPHINE AS INTRATHECAL ADJUVANT TO HYPERBARIC BUPIVACAINE IN LOWER LIMB SURGERIES.

Background and Aims: Intrathecal adjuvants are used to prolong the duration of block and provide post operative analgesia. Nalbuphine and Buprenorphine are mixed agonist-antagonist opioids which prolongs duration of block with fewer side effects. The study aimed to compare nalbuphine and buprenorphine as intrathecal adjuvant to hyperbaric bupivacaine in lower limb surgeries. Materials and Methods: In a prospective, randomized, double blind study, forty-six patients of ASA class I and II scheduled for lower limb surgery were enrolled. Patients were randomly allocated into two groups of 23 each to receive 15 mg hyperbaric bupivacaine with either 1 mg nalbuphine (group N) or 60 µg buprenorphine (group B) intrathecally. Results: Patients who received intrathecal buprenorphine (group B) had significantly delayed onset of sensory block compared to patients who received nalbuphine (group N). The time to two segment regression was significantly prolonged in group B (93.91±17.19 minutes) as compared to group N (85.65±9.33 minutes) [P <0.05]. The onset and duration of motor block was comparable among two groups. Duration of spinal analgesia was significantly prolonged in group B (276.96±39.11 minutes) as compared to group N (233.04±31.03 minutes) [P <0.05]. The post operative analgesic requirement was significantly less in group B compared to group N [P <0.05]. Hemodynamic effects and incidence of side effects were comparable among two groups. Conclusion: Intrathecal buprenorphine 60 µg provides good post operative analgesia when used as an adjuvant to 0.5% hyperbaric bupivacaine in lower limb surgeries as compared to 1 mg nalbuphine. [ABSTRACT FROM AUTHOR]