Priti Das1, Debasish Swain2, Roopa Parida3, Lucy Das4
BACKGROUND
Managing pain and stress during and after any surgical procedure is a real
challenge and a matter of concern for both surgeons and anaesthesiologists.
Various analgesics like tramadol and nalbuphine have been used as adjuncts to
anaesthetic agents with different efficacy. We wanted to do a comparative
assessment of efficacy between intravenous (IV) administration of tramadol and
nalbuphine in managing perioperative pain and stress.
METHODS
This was a single blinded randomised control trial, which included 60 female adult
patients in the age group of 30 - 50 years who were posted for surgical procedures
like elective vaginal hysterectomy under spinal block. Patients with comorbidities
like diabetes, obesity, hypertension, impaired pulmonary function, recent history
of medication with selective serotonin reuptake inhibitors were excluded from the
study. Study participants were divided into two groups - group tramadol (TR) and
group nalbuphine (NA) with 30 patients in each group. Group TR was given
tramadol 0.5 - 0.7 mg / Kg whereas group NA was given nalbuphine 0.1 - 0.2 mg
/ Kg after an hour of spinal block. Both drugs were administered intravenously.
Midazolam 0.01 - 0.05 mg / Kg was administered intravenously within first hour
of surgery for sedation. Pain, stress and sedation score, requirement of rescue
analgesics and occurrence of adverse drug reactions (ADRs) over 12 hours postoperatively
were compared.
RESULTS
Significant lowering of pain and stress scores and higher sedation score was
observed in group NA in comparison to group TR. The requirement of rescue
analgesic and occurrence of side effects like nausea and vomiting were less in
group NA.
CONCLUSIONS
Intravenous administration of nalbuphine was found to be more effective in
perioperative control of pain and stress and can be a better choice than
intravenous tramadol.
