A Comparative Study of Intravenous Nalbuphine HCl and Tramadol HCl for PostOperative Pain Relief Following Orthopaedic Surgeries

Abstract

Background: Post-operative pain is usually nociceptive but surgical trauma also induces central and peripheral sensitization and hyperalgesia .Our aim of this study was to compare the post-operative analgesic efficacy & side effects of Nalbuphine and Tramadol in orthopaedic surgeries. Methods: Eighty patients of ASA grade I & II were randomly selected with forty patients in each group. All procedures were done under regional or general anaesthesia or combination of both techniques. Patients were assessed every 30 mins for pain scores on VAS in post operative period. Group N: received inj Nalbuphine HCL 0.15 mg/kg IV 8 hourly. Group T: received inj Tramadol HCL 2 mg/kg IV 8 hourly. Time of drug administration , patients VAS at drug injection , time to onset of drug effect (VAS reduced to< 4) ,VAS score , vital signs, sedation score, complications and requirement of rescue analgesia were observed thereafter Results: Onset of drugs effect and the duration of analgesia after first dose were comparable. Nalbuphine was proven to be having longer duration than Tramadol after third dose (p<0.005). There was statistically significant hemodynamic stability and higher sedation scores in Nalbuphine group (P<0.005). Nausea, vomiting and rescue analgesics used were significantly high in tramadol group (P<0.005). Conclusion: Nalbuphine produces better pain relief and hemodynamic stability in postoperative period in patients undergoing orthopaedic surgeries when compared to tramadol which is associated with more nausea,vomiting and rescue analgesic requirement.