Objective: To compare Nalbuphine with Dexmedetomidine for postoperative analgesia in laparoscopic cholecystectomy.
Methodology: This study was done at Anesthesia Department, Rawal Institute of Health Sciences Islamabad from 15thApril 2019 to 30thSept 2019. Sixty patients (30 in each group) with age 20-60 years having ASA10physical status class I, II, undergoing elective laparoscopic cholecystectomy were included. Group-A, patients were given injection Nalbuphine 0.1mg/kg at induction of anesthesia and group B patients were given injection Dexmedetomidine 1µg/kg 15 min before induction. After premedication with injection Midazolam 2 mg I/V and inj. ondansetron 4mg I/Induction of anesthesia was done with injection Propofol 2mg/kg. Injection paracetamol 1 gm was given intravenously in all patients. Anesthesia was maintained by mixture of 50% nitrous oxide in oxygen and 2% sevoflurane. Injection cisatracuium 20µg/kg was used for maintenance of muscle relaxation.
Standard hemodynamic monitoring was done intraoperatively. At the end of surgery, residual neuromuscular blockade was reversed by injection neostigmine 30µg/kg along with atropine 15µg/kg intravenously. Patients were extubated and monitored in recovery room and were followed postoperatively for onset of pain (VAS used for assessment) and total analgesic requirement in 24-hours (in equivalent doses of morphine) post-operative nausea vomiting, sedation score and shivering. Statistical analysis was done by SPSS 21.
Results: There was no statistically significant difference in demographic profile, intraoperative hemodynamic parameters in two groups except for post extubation phase when a sudden rise was observed in HR and BP in Nalbuphine group. There was statistically significant difference in postoperative onset of pain (279/734 minutes with p value 0.000), VAS score (6.6/3.07 with p-value 0.000), 24 hour analgesic requirement in equivalent dose of morphine (17/10 mg with p value 0.000), sedation score (p value 0.000), postoperative shivering (63.3% versus 16.7% with p value 0.000) and postoperative vomiting (70% versus 20% with p value 0.000) in both groups A and B, respectively. However no difference was observed in incidence of hypotension (6.7% versus 3.3% with p value 0.554) .
Key words: Laproscopic cholecystectomy, nalbuphine, dexmedetomidine.
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