STUDY OF ANALGESIC-NALBUPHINE AS A COMPONENT OF BALANCED ANAESTHESIA IN OTOLARYNGORHINOLOGICAL SURGERY

Back ground: Use of proper analgesics as adjuvant to balanced anaesthesia can calm the patient, reduce stress and decrease the need of higher doses of inhalation agents. Some examples of analgesics are opioids, NSAIDS, NDMA receptor antagonists (ketamine). Nalbuphine is a synthetic opioid agonist-antagonist analgesic of the phenantherene series. We conducted this study with the aim to observe the effect of nalbuphine as an adjuvant to balanced anaesthesia on intra operative hemodynamics and analgesic requirement in perioperative period. Material and method: prospective, observational study was carried out in 70 adult patient of ASA grade II -III, aged 18 to 60 years, undergoing otolaryngorhinological surgeries. After informed consent patients were given routine premedication given with inj. Nalbuphine 0.1 mg/kg i.v. General anaesthesia was given and subsequent 1/5^th doses of the drug administered at every 30 minutes intra operatively. Intra operative hemodynamic monitoring was done. In post-operative period inj. Diclofenac 1.5 mg/kg i.m as a rescue analgesic was given when VAS score was ≥ 4. Observation results: Maximum rise in pulse rate and mean blood pressure were 15.48% and 8.44% respectively immediately after intubation. Intra-operatively patients remained hemodynamically stable. Average dose of nalbuphine used during intra operative period was 0.12 ± 0.01 mg. Post operative duration of analgesia was 446 min (7.16 h).10 patients had nausea and 7 patients had vomiting post operatively. Conclusion: Nalbuphine provided better analgesia and greater haemodynamic stability with fewer side effects as a component of balanced anaesthesia