Publications

Abstract
Introduction:Poplitealnerveblockisausefultechniqueforankleandfootsurgeriesasitavoidscomplications
inelderlywhoareproneforhemodynamicchangesleadingtoincreasedmorbidityandmortality.Thereis
advantageofearlypostoperativemobility which is essentialin orthopaedic surgeries andabsenceof post
duralpunctureheadache.Nalbuphineisaderivativeof14-hydroxymorphinewhichisastronganalgesicwith
mixedkagonistandμantagonistaction.TheprimaryaimofstudyistoevaluateeffectofaddingNalbuphine
toBupivacaineinpoplitealnerveblockintermsofonsetanddurationofsensoryandmotorblockadeand
duration of analgesia. Study Design: A prospective randomised comparative clinical study. Materials and
Methods:Afterobtaininginstitutionalethicalcommitteeclearance.Sixtypatientsbetween18-70yearsofeither
sexwithASAstatusI,II,IIIpostedforankleandfootsurgeriesweregroupedrandomlyintotwogroupsusing
simplesealedenvelopemethodwith30ineachgroup.Aftergettinginformedconsentfrompatientsdetailed
pre anaesthetic evaluation was done on previous day of surgery. Group A received 20ml of Bupivacaine
with1mlofnormalsalineandgroupBNreceived20mlofBupivacainewith1mlof10mgNalbuphine.Data
presentedasmeanandstandarddeviation.Thet-testwasusedtoexaminethedifferencesbetweenmeans.
Statisticalsignificancewasacceptedforap<0.05.Results:Sensoryblockade:InourstudywefoundthatGroup
BNpatientswhoreceivedNalbuphineasadditiveprovidedfasteronsetofsensorylevelblockagewithmean
timeofonsetvaluebeing11.8±2.4(inmins)comparedtoGroupAwheremeanvaluewas15.20±1.80(in
mins).Theresultswerestatisticallysignicantwithapvalueof<0.001**.Thedurationofsensorylevelblock
inGroupBNwhoreceivedNalbuphineasadditivewas760±23.3comparedtoGroupAwheremeanvalue
was552±19withstatisticallysignicantpvalueof<0.001**.Motorblockade:InourstudywefoundthatGroup
BNpatientswhoreceivedNalbuphineasadditiveprovidedfasteronsetofmotorlevelblockagewithmean
timeofonsetvaluebeing14.7±1.5(inmins)comparedtoGroupAwheremeanvaluewas17.6±1.1(inmins).
Theresultswerestatisticallysignicantwithapvalueof<0.001**.ThedurationofmotorlevelblockinGroup
BNwas573±20.6comparedtoGroupAwheremeanvaluewas438±18.4withstatisticallysignicantpvalue
of<0.001**.Conclusion:Thisstudydemonstratesthatadditionof10mgnalbuphinetobupivacaineinpopliteal
nerveblock in patientsundergoingankle andfoot surgeries decreases time of onset of anaesthesia,shows
signicantincreaseindurationofsensoryandmotorblockadeandalsoincreasesthepostoperativeanalgesia.
Keywords:Poplitealnerveblock;USGguided;Bupivacainenalbuphine