Effect of Nalbuphine as an adjuvant to 0.5% Bupivacaine for supraclavicular brachial plexus block

BACKGROUND: Brachial plexus block is most common regional anaesthetic technique for upper arm and hand surgeries. Nalbuphine is a derivative of hydroxymorphine with mixed agonist, antagonist properties and is a strong analgesic. The present study was carried out to evaluate the effect of Nalbuphine added to 0.5% Bupivacaine for supraclavicular brachial plexus block. MATERIALS AND METHODS: 60 adults patients posted for forearm and hand surgeries under supraclavicular brachial plexus block were divided into two equal groups in a randomised double blind manner. Gr I ( n=30) received 29 ml 0.5% Bupivacaine + 10 mg Nalbuphine hydrochloride ( 1 ml). Gr II received 29 ml of 0.5% Bupivacaine + 1 ml Normal Saline (0.9%). Study drug was administered in supraclavicular brachial plexus block by B. Braun Stimuplex HNS12 peripheral nerve stimulator. Following parameters were studied. Onset time, duration of sensory and motor block, time to first analgesia use. Post operative analgesia was evaluated by visual analog scale  ( VAS) score, hemodynamic changes and side effects were recorded after block. RESULTS : Onset time was comparable in both the groups.&nbsp

Original Article Section: Anaesthesia Intravenous Ketorolac Tromethamine for Prevention of Postoperative Sore Throat

ABSTRACT Background: Postoperative sore throat is a complication associated with endotracheal intubation. Many pharmacological methods have been employed to treat and prevent it. Ketorolac has been shown to be effective for treatment of pain of surgery. Here we have tried to study its efficacy in prevention of sore throat caused by endotracheal intubation. Methods: With permission from the ethics committee, a double blind random study was conducted on forty consenting adult patients of both sexes belonging to ASA I or II. They were divided into two groups K and C containing twenty each. Group K patients were given Inj. Ketorolac intravenously 10 minutes before induction. Group C was the control group. Both the groups were premedicated with Inj. Glycopyrrolate, Inj. Midazolam and Inj. Pentazocin; induced with Inj. Propofol and intubated following Inj. Vecuronium. At the end of surgery muscle paralysis was reversed with Inj. Neostigmine combined with Inj. Glycopyrrolate. The incidence of sore throat and severity were graded at 0,2,6 and 24 hours following recovery from anaesthesia with the help of Verbal Rating Scale and statistical analysis was done. Results: Ketorolac decreases post-intubation sore throat. Incidences of sore throat was 35% after extubation with Ketorolac premedication, which decreased to 5% by 6 hours. Whereas the same was 80% and 45% respectively in the control group with 35% still suffering from sore throat 24hrs post-operatively. The severity of sore throat ranged from mild to moderate in Group K patients, but varied from mild to severe in the control group. Ketorolac premedication delayed the demand for postsurgery rescue analgesia. Conclusion: Intravenous premedication with the anti-inflammatory drug Ketorolac tromethamine can prevent sore throat induced by laryngoscopy and endo-tracheal intubation and delay post-surgical analgesic requirements