Comparative Evaluation of Ropivacaine Alone with Ropivacaine Nalbuphine Combination in Supraclavicular Brachial Plexus Block for Upper Limb Surgery

ABSTRACT

Background and Aims: The benefit of post-operative analgesia in regional block is short lived due to limited duration of theaction of local anesthetics. Various adjuvants have been tried to enhance the duration of analgesia. The aim of this study wasto evaluate the analgesic efficacy and safety of nalbuphine as an adjuvant to 0.5% ropivacaine for supraclavicular brachialplexus block.Materials and Methods: A prospective, randomized, double-blind study was conducted on 60 patients of American Societyof Anesthesiologists physical Status I/II aged 18–60 years scheduled for upper limb surgeries under supraclavicular brachialplexus block. The patients were randomly allocated into two groups of 30 each to receive either 30 ml of 0.5% ropivacainewith 1 ml of normal saline (Group R) or 30 ml of 0.5% ropivacaine with 1 ml (10 mg) of nalbuphine (Group RN). The onset andduration of sensory and motor block, duration of analgesia, and side effects were noted.Results: The mean onset time for a complete sensory and motor block in Group RN was shorter (8.37 ± 0.79 min; 17.67 ± 1.07 min)as compare to Group R (10.9 ± 1.11 min; 19.17 ± 0.86 min). The mean duration of sensory and motor block in Group RN waslonger (725.67 ± 16.06 min; 420.33 ± 14.94 min) as compare to Group R (473.0 ± 22.67 min; 359.67 ± 26.89 min). The meanduration of analgesia in Group RN was 846.33 ± 72.50 min and in Group R was 588.0 ± 27.37 min. All results were statisticallysignificant (P < 0.0001). No significant side effects were observed in any of the two groups (P > 0.05).Conclusion: Nalbuphine as an adjuvant to ropivacaine in the supraclavicular brachial block significantly shortens the onsettime for sensory and motor block and prolongs the duration of sensory and motor blocks with longer duration of post-operativeanalgesia.