Nalbuphine and pentazocine in opioid benzodiazepine sedative technique in ear surgery under local anaesthesia –a double blind comparison

Introduction: The use of local anaesthesia and intravenous sedation for middle ear surgeries is long established and has many advantages. Good sedation is mandatory to alleviate different discomforts associated with these surgeries under local anaesthesia. Opioid- benzodiazepine sedation is common technique used for many procedures. Both pentazocine and nalbuphine are nalorphine like opioid agonist antagonist drugs. This study was undertaken with an aim to compare two opioid-benzodiazepine sedative techniques, ‘pentazocine-diazepam' and ‘nalbuphine-diazepam' for middle ear surgery under local anaesthesia. Materials and Method: Sixty patients scheduled for elective middle ear surgery between 15 to 50 years age group, of either sex having American society of anaesthesiologists physical status of 1 or 2 were included in the study to receive either pentazocine-diazepam (Group A) or nalbuphine-diazepam (Group B) sedation along with local anesthesia. Results: Ramsay sedation score was satisfactory and comparable in both groups. Respiratory and spo2 changes were safe and comparable in both groups. Intra operative discomforts were minimal and easily manageable in both groups. Analgesic efficacy was good with nalbuphine having statistically significant longer duration of post operative analgesia than pentazocine (p less than 0.00001). Post operative side effects were minimal and comparable in both groups. Conclusion: Both regimens gave satisfactory results in terms of sedation, analgesic efficacy, respiratory and spo2 changes with minimal discomforts and nalbuphine being superior in terms of post operative analgesic duration.