Postoperative Analgesic Efficacy of Nalbuphine vs Dexmedetomidine as Adjuvants to Ropivacaine in Ultrasound Guided Transversus Abdominis Plane Block for Abdominal Hysterectomies: A Randomised Clinical Study
Introduction: Transversus Abdominis Plane (TAP) block has been practised as an effective alternative to systemic analgesics to achieve adequate postoperative analgesia, with minimal systemic side effects. Dexmedetomidine, an alpha-2 agonist and nalbuphine, an opioid, have been studied as adjuvan...
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| Format: | article |
| Langue: | EN |
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JCDR Research and Publications Private Limited
2021
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| Accès en ligne: | https://doaj.org/article/a3a99d5c5ece4fbdaa76161aad323443 |
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| Résumé: | Introduction: Transversus Abdominis Plane (TAP) block has
been practised as an effective alternative to systemic analgesics
to achieve adequate postoperative analgesia, with minimal
systemic side effects. Dexmedetomidine, an alpha-2 agonist
and nalbuphine, an opioid, have been studied as adjuvants to
local anaesthetics to improve the analgesic profile of regional
anaesthetic blocks.
Aim: To compare the duration and quality of postoperative
analgesia of dexmedetomidine and nalbuphine when used as
adjuvants to ropivacaine for TAP block.
Materials and Methods: This was a randomised double blinded
study conducted on 60 patients undergoing total abdominal
hysterectomies under spinal anaesthesia. Patients were randomly
distributed into two groups of 30 patients each, to receive either
39 mL of 0.2% ropivacaine+50 µg dexmedetomidine (1 mL)
(group D) or 39 mL of 0.2% ropivacaine+10 mg nalbuphine
(1 mL) (group N), for bilateral TAP block. Postoperative pain
scores, time for first rescue analgesic request and incidence of
side effects were compared.
Results: Duration of postoperative analgesia was similar in
both groups (409.14±48.92 minutes in group D vs 419.03±54.11
minutes in group N) (p-value=0.462). Postoperative pain scores
and total amount of rescue analgesic requirement (105.17±42.98
vs 106.45±46.08) was also similar in both the groups (p=0.912).
In Nalbuphine group, 16.7% reported pruritis (p-value=0.02) and
13.3% reported nausea (p-value=0.213). However, in group D
only one patient reported nausea two hours postoperatively.
Conclusion: Nalbuphine when compared to dexmedetomidine,
as an additive to ropivacaine for TAP block, provides similar
postoperative analgesic duration and efficacy, but increases the
incidence of pruritus and nausea. |
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