Intrathecal Nalbuphine versus Ketamine with Hyperbaric Bupivacaine in Lower Abdominal Surgeries

Spinal anesthesia is an effective method of anesthesia with fewer side effects. The main limitations include the shorter duration of action and shorter postoperative analgesia when performed only with local anesthetics.

The aim of this study is to compare adjuvants nalbuphine and ketamine to hyperbaric bupivacaine in spinal anesthesia with respect to the duration of analgesia, sensory and motor onset, hemodynamic status, and side effects.

This was a prospective, randomized, double-blind study.

After ethical committee's clearance and informed consent, 90 patients of the American Society of Anesthesiologists physical status I and II were randomly allocated in three groups N, K, and B who received 3 ml hyperbaric bupivacaine with 0.8 mg nalbuphine, 3 ml hyperbaric bupivacaine with 25 mg ketamine (preservative free), and 3 ml hyperbaric bupivacaine with 0.5 ml normal saline, respectively.

Data were analyzed using paired t-test. Results were analyzed and compared to previous studies. SPSS-22 version of software was used, released 2013, IBM Corp., Armonk, NY, USA.

Mean duration of analgesia in Group N, K, and B was 290 ± 6.09, 220 ± 5.03, and 154 ± 6.04 min, respectively. Mean time of sensory onset in Group N, K, and B was 2.08 ± 0.34, 3.5 ± 0.25, and 4.5 ± 0.37 min, respectively. Time of motor onset was 7.60 ± 0.58, 7.79 ± 0.37, and 7.82 ± 0.53 min in Group N, K, and B, respectively.

Nalbuphine is an effective adjuvant in spinal anesthesia with respect to sensory onset, duration of analgesia, and hemodynamic stability.