Efficacy of nalbuphine for suppression of hemodynamic responses to pneumoperitoneum- A prospective randomised controlled study

Pneumoperitoneum created during laparoscopic surgeries induces significant hemodynamic changes. This study was aimed to explore the efficacy of nalbuphine to suppress hemodynamic responses to pneumoperitoneum.This was a prospective randomised controlled study conducted on 80 ASA I/II patients between 18-60 yr after institutional ethics committee approval and written informed consent. Presence of pregnancy, multiple drug therapy, cardiovascular, renal or hepatic diseases were taken as exclusion criteria. Based on a computer generated random number table patients were allocated to one of the two groups; Group N: Nalbuphine 0.3 mg/kg and Group S: Normal saline. Hemodynamic parameters, time to request of rescue analgesic, sedation and side effects were recorded. Data was analysed using student t-test and Chi square/Fisher’s exact test, repeated measure ANOVA. A p-value<0.05 was taken as significant. Group N patients had lower heart rate after test drug and for the first 30 min and on deflation of pneumoperitoneum. The mean and systolic blood pressure decreased at the time of creation of pneumoperitoneum (p<0.001). VAS score was significantly lower in the first 30 min postoperatively in group N (p=0.004). Number of patients who requested for rescue analgesic within 2 h postoperatively, incidence of PONV and shivering were comparable. Sedation was higher in immediate postoperative period in group N (p=0.002). Nalbuphine provides stable hemodynamics for first 30 min after creation of pneumoperitoneum for laparoscopic procedures. It also provides postoperative analgesia for a short duration of 30 min.