COMPARATIVE STUDY OF FENTANYL, TRAMADOL AND NALBUPHINE IN ATTENUATION OF HAEMODYNAMIC RESPONSES IN LAPAROSCOPIC CHOLECYSTECTOMY

Background:-Numerous attempts have been made in the past to attenuate the haemodynamic responses occurring during laparoscopic cholecystectomy. The present study compared the effect of three opioids namely TRAMADOL, Fentanyl and Nalbuphine in obtundation of haemodynamic responses in laparoscopic cholecystectomy in terms of Heart rate, BP (SBP, DBP and MAP) and secondary aim was to calculate duration of analgesia and sedation score.

Materials And Methods:-This was a randomised study comparing three opioid drugs- nalbuphine, fentanyl and TRAMADOL. It was carried out on 75 patients of either sex aged 18 - 60 years scheduled for elective laparoscopic cholecystectomy under GA. Subjects were enrolled into three groups- Group B (n= 25) patients received inj. TRAMADOL 2 mcg/kg IV, Group F (n= 25) received inj. Fentanyl 2 mcg/kg IV and Group N (n= 25) patients received inj. Nalbuphine 0.2 mg/kg 5 minutes before the induction.

Result:-At the time of extubation, mean MAP in Group B, F and N was 99.88, 95.32 and 97.24 respectively. This difference is highly significant when compared statistically (p value is 0.005).

Conclusion:-With this study, we conclude that the administration of intravenous fentanyl and nalbuphine five minutes prior to induction of anaesthesia helps in better obtundation of haemodynamic responses to laparoscopic cholecystectomy than TRAMADOL.