dexamethasone + nalbuphine + bupivacaine

This is an investigational anesthetic protocol developed by researchers at Mansoura University for managing postoperative pain in patients undergoing lower abdominal oncologic surgery. The technique utilizes a combined spinal-epidural approach: epidural administration of dexamethasone (a synthetic corticosteroid with anti-inflammatory properties) followed by intrathecal administration of nalbuphine (a mixed kappa-opioid receptor agonist and mu-opioid receptor antagonist) and bupivacaine (a long-acting amide local anesthetic). Dexamethasone acts to reduce local inflammation and potentially prolong the effect of the block, while nalbuphine provides visceral analgesia with a lower incidence of mu-opioid-related side effects like pruritus and respiratory depression. Clinical studies indicate that this combination significantly prolongs the duration of effective analgesia and reduces the need for rescue analgesics compared to standard spinal anesthesia.

Other names

Dexamethasone-nalbuphine protocolEpidural dexamethasone with intrathecal nalbuphine and bupivacaine