Comparative Study Dexmedetomidine with Nalbuphine as Adjuvant to Intrathecal Hyperbaric Levobupivacaine for Lower Limb Orthopedics Surgeries

Abstract

Background: Nalbuphine and Dexmedetomidine (DEX) are being used along with hyperbaric Levobupivacaine as an adjunct to produce early onset; prolong duration of block and maintain hemodynamic stability. In literature limited studies are available assessing the impact of Nalbuphine and DEX as adjuvants with different local anaesthetics. Thus present research was done to compare both DEX and Nalbuphine as adjunct to Hyperbaric Levobupivacaine in orthopedic lower limb surgeries. Materials and Method: Present comparative study was done on 60 patients aged 18-60yrs, subjected to lower limb orthopedic surgeries, randomly assigned into two groups Group LD (Levobupivacaine+ Dexmedetomidine) and Group LN (Levobupivacaine +Nalbuphine). Hemodynamic parameters, pain score, onset and duration of sensory and motor blocks were evaluated. Data was assessed using statistical analysis with SPSS version 20.0 software (IBM Chicago).  Results: Mean onset and duration of sensory and motor block was more in group LD than LN. Mean time for first rescue analgesia was comparable (p>0.05) but more in group LD than LN. Mean total analgesia consumption was comparable (p>0.05) but more in group LN than group LD. More number of cases in group LN showed VAS score >4, than group LD at 8hrs and 16hrs, revealing insignificant (p>0.05) difference between both the groups. Conclusion: During lower limb orthopaedic procedures, both dexmedetomidine and nalbuphine are proved to be useful supplements to bupivacaine. In our study, dexmedetomidine considerably lengthens sensory-motor block and post-op analgesia duration than nalbuphine.

Keywords: Orthopedic; Lower limb; Levobupivacaine; Nalbuphine