DefinePK

Research Objective

To compare the efficacy of Nalbuphine alone versus Nalbuphine with Ketorolac for the management of pain in patients undergoing open cholecystectomy under general anaesthesia.

Methodology

Comparative prospective study involving 150 patients divided into two groups. Group A received Nalbuphine (0.12 mg/kg) and Group B received Nalbuphine (0.06 mg/kg) with Ketorolac (15 mg). Postoperative pain intensity was assessed using the Numerical Pain Rating Scale at 5 minutes, 30 minutes, and 1 hour. Rescue analgesia, nausea, vomiting, and sedation were also documented.

Methodology Flowchart

                        graph TD
    A["Patient Recruitment & Consent"] --> B["Divide into Group A: Nalbuphine; Group B: Nalbuphine + Ketorolac"];
    B --> C["Administer Anesthesia and Study Drugs"];
    C --> D["Monitor Patients Post-Surgery"];
    D --> E["Assess Pain Intensity, Nausea, Vomiting, Sedation"];
    E --> F["Document Rescue Analgesia Needs"];
    F --> G["Data Analysis"];
    G --> H["Conclusion"];                    

Discussion

The study suggests that Nalbuphine alone at a higher dose (0.12 mg/kg) provides better pain management and reduces the need for rescue analgesia after open cholecystectomy under general anaesthesia compared to a combination of lower-dose Nalbuphine and Ketorolac. While Ketorolac is known for its analgesic properties with fewer opioid-like side effects, this study indicates that Nalbuphine alone may be superior in this specific context. The findings are discussed in relation to existing literature on postoperative pain management.

Key Findings

Intravenous Nalbuphine (0.12 mg/kg) alone was more effective in reducing pain intensity and postoperative analgesic requirements compared to Nalbuphine (0.06 mg/kg) with Ketorolac (15 mg). Rescue analgesia was significantly lower in Group A (13.3%) compared to Group B (73.3%) (p=0.001). A statistically significant difference in pain scores was observed between the groups (p < 0.001). Sedation was higher in Group A (10.7%) than in Group B (5.3%).

Conclusion

Intravenous Nalbuphine (0.12 mg/kg) is more effective in reducing pain intensity and the need for postoperative analgesics after open cholecystectomy compared to the combination of Nalbuphine (0.06 mg/kg) and Ketorolac (15 mg). It is considered safe due to a very low incidence of postoperative complications.

Fact Check

1. Sample Size: The study included a total of 150 patients, with 75 patients in each group (Group A and Group B).
2. Duration of Study: The study was conducted from June 2019 to March 2020.
3. Rescue Analgesia Frequency: Rescue analgesia was required in 13.3% of cases in Group A and 73.3% of cases in Group B.

Mind Map