Comparison of Nalbuphine / Fentanyl as Opioid Adjuvant to Propofol based TIVA for Laser Surgery of Larynx

Background: Laser surgeries of larynx are very much common. There are chances of combustion during laser application. To prevent it TIVA with propofol is very much important. Aims and Objective: To compare Nalbuphine and fentanyl as analgesic adjuvant, in total intravenous anaesthesia with propofol infusion in laser surgery of larynx. Study design: Double blind randomised. Methods: Changes in haemodynamic variables greater than twenty percent above or below the baseline and recovery profile were observed. Results: Blood pressure remained within 20% of baseline in either group. Nine patients in fentanyl and fifteen in nalbuphine group required an additional bolus of propofol intraoperatively. Heart rate response after tracheal intubation was significantly higher in the nalbuphine group (25%). No difference was observed in the incidence of nausea and vomiting in the recovery room. Twenty-seven percent patients in the nalbuphine group required analgesia in the recovery in comparison to 87% in the fentanyl group. Patients in the fentanyl group required analgesia earlier (37 minutes vs. 62 minutes). Conclusion: Fentanyl provided better intraoperative haemodynamic stability in comparison to nalbuphine when used as the analgesic component in total intravenous anaesthesia with propofol. The recovery profile with both drugs was similar. Lesser number of patients required analgesia in the recovery in the nalbuphine group.