A comparative study to know the efficacy of intrathecal nalbuphine versus intrathecal fentanyl as an adjuvant to bupivacaine for lower limb surgeries

During preoperative visit patient’s detailed history,general physical examination and systemic examination will be carried out.History of any significant medical illness will be elicited. Airway,respiratory system and cardiovascular system will be assessed.

Only ASA grade І and ІІ patients withinthe age group of 18 to 60 years of either sex undergoing elective lower limb surgerieswill be included in our study. A written informed consent will be taken.

Patientwill be shifted to operation table, IV access will be obtained on forearm with18 Gauge IV cannula and Ringer’s lactate solution 500ml will be infused intravenouslybefore the block. The monitors will be connected to patient which include non-invasiveblood pressure. Oxygen saturation using pulse oximeter.  Baseline PR, BP and SpO2 will be recorded.

Under strict aseptic precautions, lumbarpuncture will be performed in left lateral position by midline approach byusing 26G Quincke spinal needle at L3-L4 intervertebral space and study drugwill be injected intrathecally after confirming clear free flow of CSF. Patient’svitals will be monitored continuously using mutli-parameter monitor. Afterspinal anaesthesia, Oxygen (5L/min) by facemask will be given, Fluid therapywill be maintained with Lactated Ringer’s solution (10ml/kg/hr).