Open AccessA Comparison between Intrathecal Nalbuphine and Fentanyl for Intraoperative Pain Management during Uterine Exteriorization in Cesarean Section: A Randomized Controlled Trial
Author(s) -
Sherif Abdullah Mohamed,
Ahmed Elsonbaty,
Mohamed Elsonbaty
Publication year - 2021
Publication title -
open access macedonian journal of medical sciences
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.288
H-Index - 17
ISSN - 1857-9655
DOI - 10.3889/oamjms.2021.6531
Subject(s) - medicine , nalbuphine , fentanyl , anesthesia , randomized controlled trial , visceral pain , shivering , analgesic , nausea , opioid , saline , incidence (geometry) , surgery , nociception , physics , receptor , optics
BACKGROUND: Uterine exteriorization during cesarean section is linked to an increased incidence of visceral pain. AIM: This study explored the ability of intrathecal nalbuphine to alleviate this accompanied pain to be used as an effective safer alternative to fentanyl, as there is almost no study compared between these agents to alleviate visceral pain induced by uterine exteriorization.METHODS: This double-blinded randomized controlled research was done on 135 cases subjected to cesarean section with exteriorization of the uterus. Patients were randomized equally into F, N, and C groups which received 25 μg fentanyl, 800 μg nalbuphine, and 0.5 ml saline, respectively, added to intrathecal 0.5% hyperbaric bupivacaine. The occurrence of visceral and shoulder pain and their VAS, the need for rescue IV fentanyl, adverse events, hemodynamics, and Apgar scores were evaluated.RESULTS: The incidence of visceral pain was 22.2%, 24.4%, and 66.7% for Groups F, N, and C, respectively. Patients who needed rescue IV fentanyl were 6.7%, 11.1%, and 60% for Groups F, N, and C, respectively. The statistical difference regarding these parameters was highly significant (p < 0.0001) between C group and both F and N groups but insignificant between F and N groups. Nausea, shivering, itching, and bradycardia were significantly lower (p < 0.05) in N group in comparison to F and C. HR had a significant difference between F group and both N and C groups.CONCLUSION: Intrathecal nalbuphine is an effective safer alternative to fentanyl to control visceral pain induced by uterine exteriorization during cesarean delivery.