ABSTRACT
In this double blind randomized study we compared. The effects of epidural nalbuphine to intravenous [IV] nalbuphine on the epidural morphine in patients undergoing elective major abdominal surgery. G[M] [control group] received epidural mixture of bupivacaine 0.5% 1mg/kg and preservative free morphine 150 micro g/ml bupivacaine G[M-epiN] received epidural mixture of bupivacaine 0.5% 1mg/kg and preservative free morphine 150 micro g /ml bupivacaine and preservative and buffer free nalbuphine 30 micro g/mL bupivacaine G[MivN] received epidural mixture of bupivacaine 0.5% 1mg/kg and preservative free morphine 150 micro g/ml bupivacaine and preservative and buffer free nalbuphine 0.1mg/kg [IV] There was no significant changes in analgesia score or sedation score between 3 groups. Nalbuphine markedly adverse the side effects of morphine regarding haemodynamics. There was significant decrease in HR and MAP in the G[M-epiN] G[MivN] groups comparing with G[M]. Our data indicate that the addition of nalbuphine either intra venous or epidurally prevent the morphine induced side effects without reversing its analgesic effect