Nalbuphine as an Alternate Analgesic to Morphine in Total Abdominal Hysterectomy: A Prospective, Randomized, Comparative, Double-Blind Study

Pain is one of the most distressing post-operative consequences of surgeries. Opioids have been the mainstay in providing pain relief. Morphine is the considered to be the “gold standard” amongst opioids as an analgesic. Nalbuphine, a synthetic opioid agonist/antagonist has analgesic potency almost equivalent to that of morphine on a milligram basis and fewer complications like respiratory depression, sedation PONV, pruritus etc. This study was conducted to compare the efficacy of i.v. nalbuphine with i.v. morphine in terms of duration of analgesia along with the intra-operative hemodynamic profile & and post-operative side effects. Fifty patients belonging to ASA physical status I & II, scheduled to undergo elective total abdominal hysterectomy under GA were included in this prospective, randomized, double blinded trial to receive either intravenous morphine 0.1 mg/kg (Group M) or nalbuphine 0.2 mg/kg (Group N) before induction of general anaesthesia. The intra-operative hemodynamics, duration of post-operative analgesia & incidence of side-effects were studied. Blood pressures (SBP and DBP) post-intubation till 180 minutes postextubation were low in nalbuphine group. Duration of analgesia was significantly more in nalbuphine group than in morphine group (437±63.87 min v/s 255.0±43.75 min). Intravenous nalbuphine provided better haemodynamic stability and longer duration of analgesia compared with morphine, although sedation was found to be more with nalbuphine.