DEXMEDETOMIDINE AND NALBUPHINE VS. PROPOFOL AND FENTANYL IN MINIMALLY INVASIVE GYNAECOLOGICAL PROCEDURES: A COMPARATIVE STUDY

Shipra Singh and Prem Kumari Bhamri*

ABSTRACT

Background and aims: For a long time anaesthesiologists are in search of best suited anaesthesia technique for day care surgery to reduce hospital stay, financial burden, safety of patients and complete short procedure list within the scheduled time frame. For the above mentioned purpose we compared two sets of drugs: dexmedetomidine / nalbuphine versus propofol/fentanyl. Material and methods: 18-50 years, ASA I and II, 60 patients having BMI 18-25kg/m2 undergoing minimally invasive gynecological procedures were divided into two equal groups: ND and FP. In this double blind study Group ND received loading dose dexmedetomidine 1 mcg/kg as infusion and maintenance dose of 0.3 mcg/kg along with nalbuphine 100mcg/kg. Group FP received Propofol 2mg/kg in titrating dose with maintenance of 75 mcg/kg/min along with Fentanyl 2mcg/kg to achieve targeted RSS ≥ 4. Patient’s pulse rate (PR), mean arterial pressure (MAP), post operative analgesia demand, time to reach Modified Aldrete score of 10 were recorded. Results: At the start of procedure there was a considerable decline in pulse rate in group ND as compared to group FP (p<0.001) which persisted throughout the procedure. There was fall in MAP in both the groups but it was more in group FP (p<0.001) and was persistent. 20% of the patients in group FP demanded rescue analgesia as compared to none in group ND in postoperative period. The mean duration to reach the Aldrete score of 10 in group ND was 65.5±3 minutes and 75.4±1 minutes in group FP which was statistically significant (p<0.0001). Conclusion: The combination of dexmedetomidine / nalbuphine found to be better because of hemodynamic stability along with longer postoperative analgesia with Lesser duration of stay in PACU.

Keywords: Dexmedetomidine, nalbuphine, propofol, fentanyl, minimally invasive procedures, aldrete score.