Anesthésie et recherche clinique
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Nalbuphine versus Morphine as Part of Intravenous Anesthesia Post Cardiac Surgery

Hoda Shokri and Ihab Ali

Objectives: The analgesic properties of nalbuphine mixed agonist antagonist opioid, in the postoperative period are well known. Our prospective study aims to compare nalbuphine and morphine as intravenous anesthetics together with propofol infusion, in the early postoperative period, following cardiac surgery.

Methods: 40 patients with ASA I-III schedueled for elective primary isolated coronary artery bypass grafting were included. Nalbuphine group (20 patients) received nalbuphine administrated by intravenous continuous infusion once arrived in cardiac intensive care unit. Morphine group (20 patients) received morphine by intravenous continuous infusion once arrived in cardiac intensive care unit. Changes in hemodynamic variables greater than 20% above or below the baseline, VAS and sedation score, receiving additional doses of analgesia and incidence of complications are all analysed in all patients.

Results: Both groups are comparable in their baseline demographic and surgical characteristics. Blood pressure remained within 20% of baseline in the nalbuphine group whereas, rise in mean blood pressure and heart rate more than 20% of base line occurred in the morphine group. 30% of patients in the nalbuphine group required additional doses of anaglesia, compared to 70% of the morphine group. VAS and sedation score were significantly better in the nalbuphine group than the morphine group. Incidence of vomiting and pruritis were significantly higher in the morphine group compared to the nalbuphine group.

Conclusion: We concluded that Nalbuphine provided better hemodynamic stability, effective postoperative pain relief, with fewer complications, compared to morphine in patients post cardiac surgery.