Hassan, K., Mahmood, H., Moustafa, I., Rezk, G. (2021). Comparative Study between Intrathecal Morphine and Nalbuphine Added to Hyperbaric Bupivacaine 0.5% in Elective Cesarean Delivery. The Egyptian Journal of Hospital Medicine, 82(1), 80-88. doi: 10.21608/ejhm.2021.137948
Khaled Mohammed Hassan; Hamza Aboalam Mahmood; Islam Khaled Moustafa; Ghada Abd el-Gaber Rezk. "Comparative Study between Intrathecal Morphine and Nalbuphine Added to Hyperbaric Bupivacaine 0.5% in Elective Cesarean Delivery". The Egyptian Journal of Hospital Medicine, 82, 1, 2021, 80-88. doi: 10.21608/ejhm.2021.137948
Hassan, K., Mahmood, H., Moustafa, I., Rezk, G. (2021). 'Comparative Study between Intrathecal Morphine and Nalbuphine Added to Hyperbaric Bupivacaine 0.5% in Elective Cesarean Delivery', The Egyptian Journal of Hospital Medicine, 82(1), pp. 80-88. doi: 10.21608/ejhm.2021.137948
Hassan, K., Mahmood, H., Moustafa, I., Rezk, G. Comparative Study between Intrathecal Morphine and Nalbuphine Added to Hyperbaric Bupivacaine 0.5% in Elective Cesarean Delivery. The Egyptian Journal of Hospital Medicine, 2021; 82(1): 80-88. doi: 10.21608/ejhm.2021.137948
Comparative Study between Intrathecal Morphine and Nalbuphine Added to Hyperbaric Bupivacaine 0.5% in Elective Cesarean Delivery
Department of Anaesthesia, Intensive Care and Pain Management, Faculty of Medicine, Sohag University, Egypt
Abstract
Background: Many additives have been used to improve spinal anesthesia; morphine and nalbuphine are commonly used drugs. Objective: This work aimed to compare intrathecal morphine and different doses of nalbuphine in elective cesarean section (CS). Patients and Methods: This double-blinded, randomized controlled study was done on 150 patients, American Society of Anesthesiologist (ASA) grade I to II undergoing elective CS. Patients underwent spinal anesthesia 3 ml with 10 mg hyperbaric bupivacaine 0.5 % with the addition of a 1 ml volume (morphine or nalbuphine) according to the group; Group M: 150 μg morphine, Group N1: 1 mg nalbuphine, and Group N2: 2 mg nalbuphine. Results: Intraoperative and postoperative hemodynamics, respiratory rate, SPO2 and Apgar score were insignificantly different in all groups. Postoperative VAS was significantly decreased in group M and was insignificantly different between group N1 and group N2. Postoperative BROMAGE was significantly higher in group M. Time of rescue analgesia was significantly increased in group M and was insignificantly different between group N1 and group N2. Postoperative nausea and vomiting (PONV) was insignificantly different in all groups, and pruritus was significantly decreased in group N1. Conclusions: As additives to hyperbaric bupivacaine in the spinal block, morphine was superior to nalbuphine in decreasing VAS and increased time for rescue analgesia by prolonged sensory block. Increasing the dose of nalbuphine up to 2 mg did not increase the analgesic effect. Nalbuphine is superior to morphine in decreasing pruritus, and both drugs have similar effects on neonatal APGAR score and hemodynamics
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