Advantages of Intrathecal Nalbuphine, Compared with Intrathecal Morphine, After Cesarean Delivery: An Evaluation of Postoperative Analgesia and Adverse Effects

Abstract

Small doses of intrathecal nalbuphine produce fewer adverse effects, such as pruritus and postoperative nausea and vomiting, compared with intrathecal morphine. This may allow earlier discharge of patients from the recovery room.

Intrathecal nalbuphine as an adjuvant to subarachnoid block: What is the most effective dose?

“…Some of the previous studies were even conducted with intrathecal nalbuphine in pregnant patients, but no neurotoxicity was reported in them. [718] The FDA in 2005 advised that nalbuphine may be used during labor and delivery only if clearly indicated and if the potential benefit outweighs the risk. We are unaware of any definite caution in the use of nalbuphine by any statutory authority in nonpregnant patients and in subjects more than 18 years old.…”

“…in 2002 used intrathecal nalbuphine in doses 0.2, 0.8 and 1.6 mg with 10 mg of 0.5% hyperbaric bupivacaine in patients undergoing caesarean section under subarachnoid block (SAB) and found 0.8 mg of nalbuphine as an effective dose. [7] But, they have not used 0.4 mg nalbuphine. Lin et al .…”

Procedural pain and anxiety in paediatric patients in a Mexican emergency department

“…Nalbuphine acts as an agonist at kappa (κ) receptors, but it behaves as an antagonist at the mu (μ) receptor (Schmidt et al. 1985, Hoskin & Hanks 1991, Culebras et al. 2000).…”

“…Its main advantages over morphine are a ceiling effect on respiratory depression, low tolerance liability and a lack of clinically significant withdrawal symptoms (Schmidt et al. 1985, Hoskin & Hanks 1991, Culebras et al. 2000).…”

“…Nalbuphine is a synthetic opioid analgesic of the phenanthrene series. Nalbuphine acts as an agonist at kappa (j) receptors, but it behaves as an antagonist at the mu (l) receptor (Schmidt et al 1985, Hoskin & Hanks 1991, Culebras et al 2000. The analgesic potency of nalbuphine is essentially equivalent to morphine on a milligram basis (Schmidt et al 1985, Hoskin & Hanks 1991, Culebras et al 2000.…”