Comparison between Spinal Anesthesia using Hyperbaric Prilocaine with Nalbuphine or Fentanyl Supplementation in Lower Limb Surgeries

Document Type : Original Article

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Department of Anesthesiology, Intensive Care and Pain Management, Faculty of Medicine, Al-Azhar University, Cairo, Egypt.

Abstract

Background: The best medications for spinal anesthesia are becoming more important as more & more surgeries are moved to outpatient facilities.
Aim of the work: This study aims to compare the length of postoperative analgesia and motor & sensory block characteristics between spinal anesthesia employing hyperbaric prilocaine, nalbuphine, & fentanyl in lower limb procedures.
Patients and methods: The research included ninety patients & was a prospective, randomized, double-blind clinical trial. at Al-Azhar University Hospitals in Cairo, & was approved by the Scientific & Ethics Research Committee. Each of the three groups consisted of thirty patients. Group P: using hyperbaric prilocaine 50 mg prilocaine only, Group PF: using hyperbaric prilocaine Fentanyl twenty-five μg with prilocaine fifty milligrams & Group PN: using hyperbaric prilocaine 50mg and 800 μg nalbuphine.
Results: In terms of age, body mass index (BMI), ASA status, sex, & operation time or type, the research found no statistically significant difference between all three groups. In comparison to groups P & PF, group PN had a substantially longer time to request the first analgesic. In addition, during four hours & twenty-four hours after surgery, group PN patients reported much less pain on the Visual Analogue Scale (VAS) than groups P & PF. The length of time that sensory and motor blocks lasted also varied significantly across groups.
Conclusion: Adjuvants to two percent hyperbaric prilocaine in a subarachnoid block, such as intrathecal nalbuphine eight hundred μg or fentanyl twenty-five μg, are effective. When compared to fentanyl, intrathecal nalbuphine prolongs sensory block, motor block, & effective analgesia while reducing the occurrence of adverse actions and complications in patients undergoing lower limb surgery under spinal anesthesia.

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