2023, Vol. 6, Issue 3, Part B

Background: Nalbuphine, a potent analgesic with both kappa agonist and antagonist properties, is a derivative of 14-hydroxymorphine. Extensive research has been conducted on the use of nalbuphine as an adjuvant to local anesthetics, specifically in axillary brachial plexus blocks, both in intravenous and spinal applications. The study aimed to assess effectiveness of nalbuphine in axillary brachial plexus blocks when used in conjunction with local anaesthetics.

Patients and Method: In two groups of 28 patients each, under axillary and branchial plexus block, 62 cases preplanned for elective forearm and hand surgery were assigned at random. The first group received 25 ml (0.5%) of bupavacaine combined with 1 ml of normal saline (NS), whereas the other received 25 ml (0.5%) bupivacaine along with 1 ml (20mg) nalbuphine. The study examined the initiation time and duration of both sensory and motor block, and the effectiveness of analgesia following the surgery.

Results: The nalbuphine group demonstrated a significant increase in motor block length (402.59±18.56) when compared to placebo group (348.70 ± 28.019), with a p-value of less than 0.001. Similarly, the nalbuphine group experienced a significantly longer sensory duration (709.14±21.04) compared to placebo group (605.18±25.33), also with a p-value of less than 0.001. The administration of nalbuphine did not affect the onset time of the blockade. Additionally, the nalbuphine group exhibited a statistically significant prolongation of the analgesic effect (825.18±32.45) when comparison done to the placebo group (718.14±44.57), with a p-value > 0.01.

Conclusion: According to the current study, axillary brachial plexus block patients who receive 20 mg of nalbuphine in addition with bupivacaine experience a considerable extension of their analgesic time. The length of both sensory and motor blocks is also greatly increased.