Spinal anaesthesia is commonly used in elderly patients who undergo transurethral resection of the prostate (TURP), especially in those with compromised cardiorespiratory functions.

Aims: To evaluate the efficacy of Nalbuphine when used as an adjuvant to Ropivacaine in spinal anaesthesia for Transurethral resection of the prostate in terms of providing adequate sensory and motor blockade along with post-operative analgesia and to look for any adverse effects.

Methods: Fifty patients of the American Society of Anaesthesiologists (ASA) physical status II and III within the age group of 60 to 80 years were chosen for a prospective randomized double-blinded comparative clinical study. Patients were divided into two groups. Group R received 2.5 ml of 0.75% Ropivacaine and 1 ml of normal saline. Group RN received 2.5 ml of 0.75% Ropivacaine and 1 mg of Nalbuphine (in 1 ml of normal saline). Sensory and motor blockade characteristics, postoperative analgesia and adverse effects if any were studied.

Statistical analysis: The data which was collected was tabulated using Microsoft Excel and analysis was done using SPSS version 16.0. Student t-test was used to analyze the demographic and hemodynamic variables. Unpaired t-test and chi-square test were used to analyze the parameters which included onset, time, duration of sensory and motor blockade and also the duration of analgesia. p-value <0.05 was taken as statistically significant and p-value <0.01 was considered as highly significant.

Results: Patients in group RN had an early onset of sensory block at T10 (4.46±0.23min v/s 5.39±0.24 min). The duration of sensory (242.31±10.36 min v/s 175.70±9.78 min) and motor blockade(150.72±5.79 v/s 126.98±3.49) along with two segment regression times were prolonged in group RN when compared to group R. Postoperative analgesia was also superior in group RN as total analgesic consumption was less in group RN (230.46±10.8 v/s 320.6±13.2).

Conclusion: The addition of 1 mg of Nalbuphine to 0.75% Ropivacaine provided a faster onset of sensory and motor blockade. Sensory and motor blockade was also prolonged. The postoperative analgesia was enhanced in group RNs with low visual analogue scale scores (VAS scores). Haemodynamic stability was well maintained without any incidence of adverse effects.