A Comparison between Intrathecal Nalbuphine and Fentanyl for Intraoperative Pain Management during Uterine Exteriorization in Cesarean Section: A Randomized Controlled Trial

Open Access Macedonian Journal of Medical Sciences

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Title A Comparison between Intrathecal Nalbuphine and Fentanyl for Intraoperative Pain Management during Uterine Exteriorization in Cesarean Section: A Randomized Controlled Trial
 
Creator Mohamed, Sherif Abdullah
Elsonbaty, Ahmed
Elsonbaty, Mohamed
 
Subject Exteriorization of the uterus
Intrathecal nalbuphine
Intrathecal fentanyl
Visceral pain
 
Description 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.
 
Publisher Scientific Foundation SPIROSKI, Skopje, Republic of Macedonia
 
Date 2021-07-05
 
Type info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
 
Format application/pdf
 
Identifier https://oamjms.eu/index.php/mjms/article/view/6531
10.3889/oamjms.2021.6531
 
Source Open Access Macedonian Journal of Medical Sciences; Vol. 9 No. B (2021): B - Clinical Sciences; 533-540
1857-9655
 
Language eng
 
Relation https://oamjms.eu/index.php/mjms/article/view/6531/5797
 
Rights Copyright (c) 2020 Sherif Abdullah Mohamed, Ahmed Elsonbaty, Mohamed Elsonbaty (Author)
http://creativecommons.org/licenses/by-nc/4.0
 

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