A comparative study of nalbuphine, fentanyl and pentazocine as intravenous analgesics for postoperative pain relief in minor general surgical procedures

Priyanka Bhot, Preeti more, Damayanti Shah


Background and aims: Postoperative pain is acute pain and can affect nearly every organ function and may adversely influence postoperative morbidity and mortality. Pharmacological management with intravenous opioids is a common, effective and   a well known method used to treat this pain. Our study aims at comparing the analgesic efficacy of nalbuphine, fentany and pentazocine as opioid analgesics for post operative pain relief in minor general surgical procedures Methods: In this prospective, double blind, randomized controlled clinical trial, 90 patients aged 18 to 60 years, ASA grade 1 or 2, posted for minor general surgery procedures, lasting less than 1 hour under general anaesthesia. Study design: Patients were randomly allocated into 3 groups, Group I (Nalbuphine) received 0.2 mg/kg of Nalbuphine hydrochloride, Group II (Fentanyl) received 2 mcg/kg Fentanyl and Group III (Pentazocine) received 0.6 mg/kg Pentazocine, intravenously prior to induction of anaesthesia.  Hemodynamic parameters, postoperative analgesia, time of rescue analgesia, respiratory depression, sedation scores and side effects were studied. Results: Pain assessed as VAS scores were not significantly different to start with (60 mins) immediate postop in all 3 groups (p= 0.84).They were lower in Group I (nalbuphine) at 120,180 and 240 mins. At 360 mins, there was no significant difference between the mean VAS across all the groups. This suggests that all three opioids, nalbuphine, fentanyl and pentazocine provide good postoperative analgesia till 240 mins (4hrs) however nalbuphine has added effect and advantage as seen from the lesser VAS and provides longer duration of analgesia. No significant differences were seen in recovery from anaesthesia. No significant side effects of nausea, vomiting, excessive sedation and respiratory depression were noted in all the 3 groups

Conclusion: Nalbuphine, a synthetic opioid agonist- antagonist provides good postoperative analgesia in minor general surgical patients as compared to fentanyl and pentazocine , hence useful in day care surgeries.


postoperative analgesia, day care surgeries, nalbuphine, fentanyl, pentazocine

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