ANALGESIC EFFICACY OF NALBUPHINE WITH KETAMINE VERSUS NALBUPHINE WITH PLACEBO IN PATIENTS OF SCIATICA IN THE EMERGENCY DEPARTMENT

Abstract

Objective: To compare

Study Design: Quasi-experimental study

Place and Duration of Study: Department of Emergency Medicine, Combined Military Hospital, Rawalpindi from January 2025- June 2025

Methodology: A total of 192 patients were analyzed, divided into Group-A (n = 96) receiving IV nalbuphine with ketamine and Group-B (n = 96) receiving IV nalbuphine with placebo. Primary variables studied were the change in pain intensity, measured as the difference in Numerical Rating Scale (NRS) scores.

Results: The median pre-treatment NRS score was 8.55 (1.2) in Group-A and 8.30 (1.1) in Group-B (p = 0.037). Pain scores at 60 minutes were 2.65 (2.2) versus 3.50 (2.1) (p < 0.001), and at 120 minutes 2.20 (1.6) versus 3.05 (1.8) (p < 0.001), respectively. The mean change in NRS from baseline at 30 minutes was significantly higher in Group-A being 4.65 (1.5) compared with Group-B 3.65 (1.5), (p<0.001). Group-A also demonstrated a markedly shorter mean time to effective pain relief 14.38 ± 5.53 minutes compared with Group-B of 22.17 ± 8.77 minutes (p < 0.001). The requirement for rescue analgesia was lower in Group-A with 0.89 ± 1.40 mg compared with Group-B of 3.91 ± 3.00 mg, (p < 0.001).

Conclusion: The study concluded that combination of IV Nalbuphine with IV Ketamine provided superior analgesia, less rescue analgesia dose, comparative safety profile and less stay in the emergency department