Assessment of Nalbuphine on Postoperative Extubation Time in Elective General Surgery Patients at Rehman Medical Institute

Abstract

Background: Since delayed extubation could increase the risk of complications and limit operating room access for other patients, postoperative extubation time was considered a crucial indicator of recovery following general anesthesia. Opioids used for intraoperative analgesia were known to affect the recovery profiles of patients, including extubation time and respiratory function, and can cause pulmonary complications in the postoperative phase, which might need reintubation of those patients. Nalbuphine, a mixed opioid agonist-antagonist, provided effective analgesia with a potentially lower risk of respiratory depression compared to conventional opioids. However, its effect on postoperative extubation time in patients undergoing elective general surgery remained unclear. Therefore, this study was conducted to evaluate the effect of nalbuphine on extubation time, which is important for recovery. Objectives: To assess how much time general surgery patients will require for extubation without sacrificing patient safety in order to observe the effect of nalbuphine. Materials and Methods:  This study was a prospective observational study, which was conducted over four months in the General OT of RMI. We used the convenience sampling technique to recruit 160 patients of adult age who were scheduled for elective surgery. A tested datasheet was used to assess patients’ responses to the Nalbuphine drug, extubation time, and any complications related to our concern about the opioid. We were using SPSS 2025 for statistical analysis of data and OpenEpi to calculate the sample size. Results: The mean extubation time was 8.13 minutes (SD ± 2.86). Eighty percent of patients achieved smooth extubation. Chi-square analysis showed no statistically significant association between demographic or clinical variables and extubation response or side effects. Sex, age group, and ASA physical status were not significantly associated with extubation response or side effects

 (p > 0.05 for all comparisons). Additionally, no significant relationship was observed between sex and ASA status (χ² = 0.673, p = .412). These findings indicate that extubation outcomes and adverse effects were comparable across all patient groups. Conclusion: Nalbuphine is an effective and safe agent for attenuating the extubation response in general surgery patients. Its dose-dependent effect on emergence timing and favourable safety profile support its routine perioperative use.

Keywords: General anesthesia, Extubation time, delayed extubation, Postoperative pulmonary complications (PPCs), Opioid-induced repiratory depression, Nalbuphine Recovery profile.