COMPARISON OF NALBUPHINE VS DEXMEDETOMIDINE FOR POST OPERATIVE PAIN IN FESS (FUNCTIONAL ENDOSCOPIC SINUS SURGERY)

Functinal endoscopic sinus surgery (FESS) is a common treatment for

chronic sinusitis, nasal polyps, and other sinus-related conditions. While

nost patients have a positive experience with FESS, post-operative pair

is a common issue that can be difficult to manage. Opioids are routinely

used to manage post-operative pain but are associated with various side

effects, including nausea, vomiting, drowsiness, and respiratory

depression. Preventative analgesia is a pain management method that

reduces pain and opioid consumption following surgery. The use of

nalbuphine and dexmedetomidine for preventive analgesia in FESS has

been gaining increasing attention in recent years.FESS is mostly

performed under general anesthesia; post-operative pain management is

critical to patient care. Preventive analgesia is a technique that involves

administering analgesics before the onset of pain to prevent or reduce

the severity of post-operative pain. Two drugs commonly used for

preventive analgesia in FESS are nalbuphine and

dexmedetomidine.Nalbuphine is a synthetic opioid agonist-antagonist

that has been shown to provide adequate analgesia with a lower

incidence of side effects compared to other opioids. Nalbuphine acts on

mu and kappa opioid receptors to produce analgesia but also has

antagonist activity at the mu receptor, which reduces the risk of

respiratory depression and opioid-induced hyperalgesia

Dexmedetomidine is a selective alpha-2 adrenergic receptor agonist that produces sedation, analgesia, and anxiolysis. Dexmedetomidine has

been shown to reduce post-operative pain and opioid consumption in

various surgical procedures.Nalbuphine is an opioid agonist-antagonist

with a mixed agonist and antagonist effect on the mu, kappa, and delta

opioid receptors. This leads to a lower risk of respiratory depression and

opioid-induced hyperalgesia.On the other hand, dexmedetomidine is a

selective alpha-2 adrenergic receptor agonist that provides sedative

analgesic, and anxiolytic effects without causing significant

hemodynamic consequences. These drugs have been used together in

several studies to assess their effectiveness in giving preventive

analgesia for FESS.Despite the increasing attention to using nalbuphine

and dexmedetomidine for preventive analgesia in FESS, there is still a

research gap in determining the optimal dosage and administration

technique for these medications. Additional research is necessary to

determine the most effective and safe preventive analgesia strategy for

reducing post-operative pain and opioid consumption in FESS patients.