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

Culebras, Xavier; Gaggero, G.; Zatloukal, Jiri; Kern, Christian; Marti, René-Andréas

doi:10.1213/00000539-200009000-00019

Cited by 65 publications

(25 citation statements)

References 13 publications

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“…Total nalbuphine dose requirement in 24 hours (mg) was significant different between groups nalbuphine group (4.5 ± 0.9 min), TAP group (8.7 ± 1.3 min) and control group (18.3 ± 2 min) Patient satisfaction showed significant intensification in nalbuphine group and TAP group (P < 0.05) as compared to control group These results went along previous results of culebras et al [16] , who reported that serial doses (0.2, 0.8 and 1.6 mg) of intrathecal nalbuphine used in combination with hyperbaric bupivacaine after cesarean sectionproduced good analgesic effect. In addition, he added that 1.6 mg intrathecal nalbuphine prolong post-operative analgesia to a lesser degree than we reported in our study but our study was superior in term of effective analgesic time than Culebras study.…”

Section: Discussionsupporting

confidence: 86%

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Ultrasound Guided Transversus Abdominis Plane Block versus Intrathecal Nalbuphine Injection for Postoperative Analgesia in Preeclamptic Patients Undergoing Cesarean Section

Attia¹,

Abo-Elhussein²,

Mustafa³

2018

JAS

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Section: Discussionsupporting

confidence: 86%

“…Intrathecal administered nalbuphine shows similar analgesic action as morphine but with lower side effects [13] . TAP block is a widely used analgesic agent approved for decreasing post cesarean delivery pain.…”

Section: Discussionmentioning

confidence: 99%

Ultrasound Guided Transversus Abdominis Plane Block versus Intrathecal Nalbuphine Injection for Postoperative Analgesia in Preeclamptic Patients Undergoing Cesarean Section

Attia¹,

Abo-Elhussein²,

Mustafa³

2018

JAS

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“…Only few studies are available to conclude that minimum dose of intrathecal nalbuphine was 2 mg to increase the duration of sensory block without its side effects. 8,9 In present study, the mean time to two segment regression and time to first rescue analgesic request was significantly delayed in patients of clonidine group when compared to nalbuphine group. Similar results were also observed by Strebel et al and Gecaj-Gashi et al .…”

Section: Discussionmentioning

confidence: 45%

Clinical efficacy of clonidine versus nalbuphine as intrathecal adjuvants to 0.5% hyperbaric bupivacaine for subarachnoid block during gynaecological procedures: a double blind study

et al. 2017

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Background: Regional anesthesia techniques for gynaecological procedures are on increasing trends due to their advantage of postoperative analgesia owing to intrathecal adjuvants. The present study was aimed to comparatively evaluate the clinical efficacy of clonidine with nalbuphine when co-administered intrathecally with 0.5% hyperbaric bupivacaine for gynaecological procedures.Methods: Regional anesthesia techniques for gynaecological procedures are on increasing trends due to their advantage of postoperative analgesia owing to intrathecal adjuvants. The present study was aimed to comparatively evaluate the clinical efficacy of clonidine with nalbuphine when co-administered intrathecally with 0.5% hyperbaric bupivacaine for gynaecological procedures.Results: The onset of sensory block was earlier in patients of Group BN (3.91±2.25 min vs 4.30±0.87 min, p=0.039). The onset of motor block was also earlier in patients of Group BN (p=0.042). The time to first rescue analgesia in patients receiving intrathecal clonidine was significantly delayed (283±14.18 min vs 231.50±26.18 min, p=0.001). Intraoperative hemodynamic changes were comparable and none of the patient suffered from respiratory depression, shivering, nausea or vomiting.Conclusions: Intrathecal clonidine as adjuvant to bupivacaine provided was clinically more effective than nalbuphine for prolonging the duration of analgesia for gynaecological procedures.

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“…In a study by Culebrass et al and Mostafa there were no gross hemodynamic changes throughout the study. 13,14 No patient in our study reported with respiratory depression as it is predominantly mediated by mu receptors and nalbuphine is a mu receptor antagonist.…”

Section: Discussionmentioning

confidence: 75%

Efficiency of nalbuphine as an adjuvant to bupivancaine in lower limb orthopaedic surgery-a prospective study

Gupta¹,

Gupta²,

Neeraj

2017

Int J Res Med Sci

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INTRODUCTIONSpinal anaesthesia is a well embraced technique for performing lower limb orthopaedic surgeries. It is simpler to perform with rapid onset of action and profound muscle relaxation. Spinal anaesthesia allows for lower drug dosage and lower incidence of failed block.1,2 Every coin has two sides. Spinal anaesthesia has a shorter duration of action and early arising postoperative pain due to which various adjuvant need to be added and their roles are being evaluated in various studies. Intrathecal administration of adjuvant drugs to local anaesthesia improves quality and duration of spinal blockage and also prolongs postoperative analgesia. Moreover, the dose and amount of local anaesthetic drugs are also reduced during subarachnoid block. 3Intrathecal opioids act synergistically with local anesthetics and thus intensifying the sensory block without having any effect ABSTRACT Background: Spinal Anaesthesia is a well-known technique of performing lower limb orthopaedic surgeries. It has a shorter duration of action and early arising postoperative pain due to which various adjuvant needs to be added and their roles are being evaluated in various studies. Intrathecal opioids act synergistically with local anaesthetics and thus intensifying the sensory block without having any effect on sympathetic blockage. The main aim of present study is to investigate and evaluate the effectiveness of intrathecal nalbuphine (preservative free) as an adjuvant and also the efficacy of nalbuphine for postoperative analgesia and its complications if there are any. Methods: A total of 60 patients were included in this study belonging to ASA I and ASA II score with normal coagulation profile. Patients were randomly divided into 2 groups of 30 patients each. Group I receiving 3 ml of hyperbaric bupivacaine 0.5%+1.0mgm of nalbuphine (preservative free) injection made in 0.5 ml normal saline intrathecally. Group II received 3 ml of hyperbaric bupivacaine 0.5%+0.5 ml injection Normal saline intrathecally. The following criteria were noted. The onset of sensory blockade and complete motor blockade highest level of sensory blockade, duration of sensory blockade, duration of motor and duration of effective analgesia were recorded. Any hemodynamic alterations were also noted. Results: The mean time for the onset of sensory blockage was 56 sec in Group I and 59 sec in Group II (control). The difference were statistically insignificant (p>0.05). The mean onset of motor blockage was 106 sec in Group I and 208 sec in Group II (control). The difference was statically insignificant. The peak onset time in Group I and Group II was 372 sec and 220 sec respectively (p>0.05). Two segment regression times for sensory blockage was prolonged in Group I (118.20±8.56 min) compared to Group II (104.56±15.20 mins). Conclusions: The duration of postoperative analgesia was 6-8 hours in Group I compared to 3-4 hours in Group II (p value= 0.0001, statistically significant).

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

Cited by 65 publications

References 13 publications

Ultrasound Guided Transversus Abdominis Plane Block versus Intrathecal Nalbuphine Injection for Postoperative Analgesia in Preeclamptic Patients Undergoing Cesarean Section

Ultrasound Guided Transversus Abdominis Plane Block versus Intrathecal Nalbuphine Injection for Postoperative Analgesia in Preeclamptic Patients Undergoing Cesarean Section

Clinical efficacy of clonidine versus nalbuphine as intrathecal adjuvants to 0.5% hyperbaric bupivacaine for subarachnoid block during gynaecological procedures: a double blind study

Efficiency of nalbuphine as an adjuvant to bupivancaine in lower limb orthopaedic surgery-a prospective study

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