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Title-: Role of Nalbuphine as an adjuvant to Ropivacaine in supraclavicular block- A Randomized Control Study

Vinod Kumar Yadav, Amit Kumar Choudhary, Mukesh Kumar Prasad, Gurdeep Singh jheetay, Amber Kumar, Razi Shahid.

Abstract
Back-ground: Nalbuphine is a strong analgesic with mixed k agonist and antagonist was studied several times as adjuvant to local anesthetics in spinal, epidural and local infiltration but very few studies on brachial plexus block. The aim of this study was to evaluate the effect of nalbuphine as an adjuvant to ropivacaine 0.75% in supraclavicular brachial plexus block.
Materials and Methods: In a Prospective, double blind study of sixty patients undergoing elective upper limb surgeries were randomized into two groups. Group R - (n = 30), 29mL of 0.75% Ropivacaine + 1 mL normal saline and in study Group N (n = 30), 29 mL of 0.75% ropivacaine + 1 mL (10 mg) nalbuphine were used for giving supraclavicular block under US (Ultra Sound) guidance. Parameters assessed were onset and duration of sensory and motor block, duration of analgesia (DOA), and any adverse events. After administration of block with above drugs, the block characteristics were assessed every 2 and 3 mins till onset of complete blockade, then hourly till the effect of block persist. Data between the groups were analyzed using independent ttest with statistical package for social science SPSS 21.0 software.
Results: There were no hemodynamic variations and no complication of technique or adverse effects due to nalbuphine occurred.
Conclusion: Nalbuphine with 0.75% Ropivacaine has significantly extended the duration of analgesia of brachial plexus block with no adverse effects.

Key words: Key words: Brachial plexus block, bupivacaine, nalbuphine, supraclavicular approach, ultrasound guidance






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