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11383

A Comparison between Post-Operative Analgesia after Intrathecal Injection of Nalbuphine versus Fentanyl as an Adjuvent to Bupivacaine after Cesarean Section

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Last updated: 24 Dec 2024

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Abstract

Background: one of the primary aims of anesthesia is to alleviate the patient's pain and agony, by permitting the performance of surgical procedures without any discomfort. Relief of postoperative pain has gained real importance in recent years considering the central, peripheral and immunological stress response to tissue injury. Any expertise acquired in this field should be extended into the postoperative period, which is the period of severe, intolerable pain requiring attention. So there is a need for extended analgesia without any side effects to achieve this goal. The use of opioids in intrathecal or epidural anesthesia has become popular to optimize postoperative analgesia. However, opioid-induced side effects, such as respiratory depression, nausea, vomiting, urinary retention and pruritus, limit their use. Aim of the Work: the purpose of this study was to assess the postoperative analgesic requirements and the spinally mediated analgesic effects of intrathecal nalbuphine as an adjunct to intrathecal bupivacaine after cesarean section in comparison to intrathecal bupivacaine plus fentanyl. Patients and Methods: eighty female patients came to Demerdash Hospital for cesarean delivery, they were randomly allocated into two equal groups (40 patients) group F and group N. Group F: Bupivacaine-Fentanyl: Patients received an intrathecal injection of 2 ml of 0.5% heavy (hyperbaric) bupivacaine plus 0.5 ml (25 µg) fentanyl. Group N: Bupivacaine-Nalbuphine: Patients received an intrathecal injection of 2 ml of 0.5% heavy (hyperbaric) bupivacaine plus 0.5 ml (0.8 mg) Nalbuphine. Results: the addition of a small dose of nalbuphine or fentanyl to bupivacaine in spinal anesthesia moderately prolonged the time of postoperative analgesia, while the duration of analgesia was more prolonged and the adverse effects were minimal with the group of nalbuphine, our result shows no significant difference, but shows significant difference in the More rapid onset of sensory block with Fentanyl than with Naluphine, more rapid Regression time to S1 dermatome with Fentanyl than with Naluphine, the duration of motor block is shorter with Fentanyl than with Naluphine, patients receive rescue analgesia 6 h postoperatively is fewer with Nalpuphine than Fentanyl. Conclusion: more rapid onset of motor block in fentanyl group than in nalbuphine group, more rapid onset of sensory block with Fentanyl than with Naluphine, more rapid regression time to S1 dermatome with Fentanyl than with Naluphine.

DOI

10.21608/ejhm.2018.11383

Keywords

Bupivacaine, Fentany, intrathecal, ACTH, PDPH, Intra-thecal

Authors

First Name

Azza Youssef

Last Name

Ibrahim

MiddleName

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Affiliation

Department of Anesthesiology, I.C.U and Pain Management, Faculty of Medicine, Ain Shams University

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Orcid

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First Name

Kareem Youssef

Last Name

Kamal

MiddleName

-

Affiliation

Department of Anesthesiology, I.C.U and Pain Management, Faculty of Medicine, Ain Shams University

Email

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City

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Orcid

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First Name

Hany Magdy

Last Name

Fahim

MiddleName

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Affiliation

Department of Anesthesiology, I.C.U and Pain Management, Faculty of Medicine, Ain Shams University

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City

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Orcid

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First Name

Ahmed Nasser

Last Name

Ahmed

MiddleName

-

Affiliation

Department of Anesthesiology, I.C.U and Pain Management, Faculty of Medicine, Ain Shams University

Email

ahmednasser_91@hotmail.com

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-

Orcid

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Volume

72

Article Issue

10

Related Issue

2135

Issue Date

2018-07-01

Receive Date

2018-08-19

Publish Date

2018-07-01

Page Start

5,485

Page End

5,489

Print ISSN

1687-2002

Online ISSN

2090-7125

Link

https://ejhm.journals.ekb.eg/article_11383.html

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https://ejhm.journals.ekb.eg/service?article_code=11383

Order

25

Type

Original Article

Type Code

606

Publication Type

Journal

Publication Title

The Egyptian Journal of Hospital Medicine

Publication Link

https://ejhm.journals.ekb.eg/

MainTitle

A Comparison between Post-Operative Analgesia after Intrathecal Injection of Nalbuphine versus Fentanyl as an Adjuvent to Bupivacaine after Cesarean Section

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Article

Created At

22 Jan 2023