A Comparison Between Post-Operative Analgesia After Intrathecal Injection of Nalbuphine Versus Fentanyl as an Adjuvent to Bupivacaine After Cesarean Section

Abstract

ne of the primary aims of anesthesia is to alleviate the patient’s pain and agony, by permitting the performance of surgical procedures without any discomfort. Relief of postoperative pain has gained real importance in recent years considering the central, peripheral and immunological stress response to tissue injury. Any expertise acquired in this field should be extended into the postoperative period, which is the period of severe, intolerable pain requiring attention. So there is a need for extended analgesia without any side effects to achieve this goal. The use of opioids in intrathecal or epidural anesthesia has become popular to optimize postoperative analgesia. However, opioid-induced side effects, such as respiratory depression, nausea, vomiting, urinary retention and pruritus, limit their use. Several investigations have shown that intrathecal or epidural administration of opioids produces a dose dependent modulation of spinal nociceptive processing in animals and humans and is not associated with sedation. The purpose of this study was to assess the postoperative analgesic requirements and the spinally mediated analgesic effects of intrathecal nalbuphine as an adjunct to intrathecal bupivacaine after cesarean section in comparison to intrathecal bupivacaine plus fentanyl.