Rashmee Vijay Chavan 1 , Sandeep Sambhajirao Kadam2 , Sheetal Kamalakar Desai 3
BACKGROUND Adenotonsillectomy/tonsillectomy is a routinely performed surgery in children and has a very high incidence of postoperative pain. This study was undertaken to compare efficacy of nalbuphine and fentanyl for post-operative pain relief in children following surgery. MATERIALS AND METHODS Sixty patients aged 5 - 15 yrs. of ASA grade I and II, scheduled for elective adenotonsillectomy/tonsillectomy were enrolled in this double-blind prospective randomised study. Patients were randomly divided into two: Group N (N= 30) received nalbuphine 0.2 mg/kg and Group F (N= 30) received fentanyl 1.5 mcg/kg respectively at the time of induction of anaesthesia. Patients were observed post-operatively by blinded observer for sedation, pain and nausea/ vomiting at 1 hr, 2 hrs. and 4 hrs. interval. RESULTS With statistical analysis using unpaired t-test for all quantitative variables and Z-test, chi-square test for qualitative variables and proportions it was observed that patients who received nalbuphine had significantly lower pain score at 1 hr (p < 0.0004), 2 hrs. (p < 0.0001) and 4 hrs. (p < 0.0001) and significantly less number of patients required additional analgesic supplement (16.6%) as compared to fentanyl group, where more number of children required additional analgesia (76.6%). Duration of post-operative analgesia was also longer in nalbuphine group. On sedation score, nalbuphine group children appeared more calm, tranquil and easily arousable. There was no significant difference observed with regard to nausea and vomiting. CONCLUSION Intravenous nalbuphine compared to fentanyl renders extended time of postoperative analgesia without added side-effect. Freedom from controlled drug act regulation makes it better option for day care surgery like tonsillectomy than routinely used fentanyl.
