A Comparative Study of Epidural Nalbuphine versus Tramadol as an adjuvant to Levobupivacaine for post operative Analgesia in lower abdominal surgeries in a tertiary care centre - A double blind randomises control trial

Postoperative pain is a common and distressing experience for patients undergoing surgery. Effective pain management is crucial for patient comfort, early mobilization, and improved recovery outcomes. While regional anesthesia techniques like epidural and spinal anesthesia provide excellent intraoperative analgesia, postoperative pain often necessitates the use of opioid analgesics.

Opioids are effective in managing postoperative pain, but they can have significant side effects such as nausea, vomiting, respiratory depression, and constipation. Therefore, there is a continuous search for safer and more effective analgesics with fewer side effects.

This study aims to compare the efficacy and safety of two commonly used opioid analgesics, nalbuphine and tramadol, as adjuvants to bupivacaine for postoperative analgesia in patients undergoing lower abdominal surgeries.

Nalbuphine, a mixed agonist-antagonist opioid, has demonstrated analgesic efficacy with a lower incidence of respiratory depression compared to full agonists like morphine.

Tramadol, a synthetic opioid with a unique mechanism of action, also provides analgesia with a relatively lower risk of respiratory depression.

By comparing the analgesic efficacy, duration of analgesia, and side effect profiles of nalbuphine and tramadol, this study will provide valuable insights into the optimal choice of opioid adjuvant for postoperative pain management in lower abdominal surgeries.