Background and Aims: The aim of current study is to compare the analgesia efficacy & hemodynamics following the use of intrathecal fentanyl and nalbuphine as adjuvants to 0.5 % isobaric ropivacaine in LSCS.

Materials and Methods: A prospective, randomized double blind comparative study was conducted on 60 patients undergoing LSCS following spinal anesthesia. Patients were randomly allocated into two groups with 30 patients in each group. Group I received ropivacaine (0.5%) 10 mg + 20 μg fentanyl and group 2 received ropivacaine (0.5%) 10 mg + 0.8 mg nalbuphine. Hemodynamics at baseline, immediately after spinal (T0), 5 min. (T5), 10 min. (T10), 15 min. (T15), 20 min. (T20), 25 min. (T25), 30 min. (T30), and 45 min. (T45) were recorded.

Results: Patients in group 1 had significantly rapid onset of sensory and motor blockade, (P<0.001), however duration of blockade was comparable in both groups (P>0.05). The mean duration of effective analgesia (VAS<3) was significantly higher in group 2 (235.67±52.96 vs. 413.00±40.24, OR=1.04, 95% CI= 1.02-1.07, P<0.001).  The requirement of rescue analgesics were less in group 2 (2.63±1.40 vs. 1.87±1.04, OR=0.62, 95% CI=0.39-0.97, P=0.019). Both groups had comparable baseline hemodynamic parameters. Systolic BP was maintained in both groups (P>0.05). Group 2 had significant decrease in diastolic and mean BP at 15, 20, 25, 30, and 45 minutes (P<0.05), but mean BP was maintained above the desired level (>60 mm Hg) throughout surgery in both groups.

Conclusion: We conclude that both intrathecal fentanyl 20 μg and nalbuphine 0.8 mg are effective adjuvants to 0.5% ropivacaine in LSCS.

Keywords: Fentanyl, nalbuphine, ropivacaine, lower segment cesarean section.

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Dr Neha Khatri

MBBS, MD Anesthesia, Department of Anesthesia, S.P Medical College & PBM Hospital, Bikaner (Rajasthan), India