Comparison of Fentanyl and Nalbuphine as an Adjuvant to 0.5% Bupivacaine for Ultrasound Guided Supraclavicular Brachial Plexus Block

Introduction: Supraclavicular brachial plexus block is a commonly used, reliable regional anaesthetic technique for surgery of the upper limb. An adjuvant such as fentanyl/Nalbuphine is used to prolong the effect of bupivacaine. Aim: To evaluate the efficacy of adding fentanyl/nalbuphine as an adjuvant to bupivacaine in Ultrasound (US) guided supraclavicular brachial plexus blockade. Materials and Methods: A total 60 ASA I and II adult patients undergoing upper limb surgeries were randomly allocated to two groups. Group A received 20 mL of 0.5% bupivacaine with 2 mL fentanyl 100 mu gm with 10 mL of normal saline and Group B received 20 mL of 0.5% bupivacaine with 2 mL of nalbuphine 20 mg with 10 mL Normal Saline (NS) for supraclavicular brachial plexus blockade. The two groups were compared for the time of onset, duration of sensory and motor blocks, hemodynamic stability, postoperative analgesia and complications. Student's t-test, chi-square test, and Mann-Whitney U-test were used for statistical analysis. Results: The onset time of sensory block (12.07 +/- 1.08 and 8.20 +/- 1.32 mintues) and motor block (16.80 +/- 1.27 and 14.03 +/- 1.22 minutes) were significantly different in between Group A and Group B. The duration of sensory block (466.87 +/- 39.84 and 719.23 +/- 19.45 minutes) and motor block (16.80 +/- 1.27 and 14.03 +/- 1.22 minutes) were significantly different in between Group A and Group B. The duration (min.) of analgesia was significanty different between Group A (660.67 +/- 31.77) and Group B (836.13 +/- 25.74). Conclusion: Nalbuphine 20 mg significantly prolongs the duration of analgesia of supraclavicular brachial plexus block as compared to fentanyl group.