Comparison of analgesic and hemodynamic effects of nalbuphine versus fentanyl: a randomized, double-blinded interventional study in patients on cardiopulmonary bypass

Background
Our study aimed to compare analgesic and hemodynamic effect of Nalbuphine vs fentanyl in patient undergoing cardiac surgery on cardiopulmonary bypass.
Study design
Prospective, double blind, randomized intervational study.
Materials and Methods
After ethical committee approval and written informed consent, 60 patients of either sex, aged between 18 to 65 yrs, ASA grade 2nd and 3rd, randomely allocated to each group. Group A received study drug Nalbuphine and group B received Fentanyl. Both the drugs were given 5 min before induction. Repeated doses of study drugs were given when BIS score >60. Haemodynamics parameters were recorded at different time intervels throughout the surgery. After extubation VAS score noted at different time interval and time of first need of analgesic (Rescue analgesia) noted when VAS >3.
Statistical analysis
All the qualitative data were analysed with chi square test and all the quantitative data were analysed with comparison of mean±SD and unpaired student t-test. The levels of significance and α - error were kept 95 % and 5 % respectively, for all statistical analyses. values <0.05 were considered as Significant (S) and value > 0.05 as statistically Non Significant (NS).
Results
The mean heart rate was statistically significantly less in group B at just after intubation and just before going on cardio pulmonary bypass (CPB) & mean arterial pressure (MAP) also was statistically significantly less at just after intubation and just after coming off CPB compare to group A. Duration of analgesia in group A (288±42.13 min) was significantly prolonged as compared with group B (207±50.04 min). This prolongation of duration of analgesia was statistically significant.
Conclusion
The present study demonstrate the benefit of Fentanyl over Nalbuphine for intraoperatively haemodynamic stability and Nalbuphine is better for post extubation longer duration of analgesia over fentanyl.