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A prospective randomized study comparing the analgesic effects of intravenous nalbuphine with intravenous tramadol on postoperative pain and postoperative analgesic requirement for patients undergoing percutaneous nephrolithotomy

AIM OF THE STUDY: 
This study compares the analgesic effects of intravenous nalbuphine with intravenous tramadol on postoperative pain and postoperative analgesic requirement for patients 
undergoing percutaneous nephrolithotomy(PCNL). 
Post-operative pain produces both acute and chronic effects. Attenuation of this pain results in attenuation of the stress response, which in turn decreases the complications and facilitates recovery during the immediate post-operative period. 
The usage of nalbuphine and tramadol when administered intraoperatively, maintains better post-operative hemodynamics, causing excellent post-operative pain 
relief. There have been few studies using intravenous nalbuphine and intravenous tramadol for postoperative analgesia. 
In this study, we randomly selected 60 patients and divided them into two groups. GROUP A received a bolus dose of Nalbuphine 0.2mg/kg, 30 mins before extubation and GROUP B received a bolus dose of Tramadol 1mg/kg, 30 mins before 
extubation. The primary outcomes measured were Post-operative visual analog score and Systolic blood pressure(SBP), diastolic blood pressure(DBP), mean arterial 
pressure(MAP), heart rate(HR), respiratory rate(RR) and oxygen saturation(Spo2). 
The secondary outcomes measured were Post-operative rescue analgesic initiation time and Side effects and any other complications. 
RESULTS: 
The mean visual analog score was less in nalbuphine group when compared to the tramadol group from 30 minutes to 8 hours time intervals, which was statistically significant. The duration of action of both the drugs was about 8 hours as the time to rescue analgesia was similar in both the groups. 
In both the groups, the hemodynamic changes and respiratory parameters in the post operative period were comparable and statistically insignificant. The nalbuphine group showed an increased occurrence of drowsiness, while the tramadol group showed an increased occurrence of nausea and vomiting. 
CONCLUSION: 
From my study, I conclude that nalbuphine appears to be an effective and safe analgesic for postoperative pain relief than tramadol in equianalgesic doses, in patients 
undergoing percutaneous nephrolithotomy, providing good sedation with minimum circulatory effects.