Analgesic Effect Comparison Between Nalbuphine and Sufentanil for Patient-Controlled Intravenous Analgesia After Cesarean Section

Sun, Shen; Guo, Yixin; Wang, Tingting; Huang, Shaoqiang

doi:10.3389/fphar.2020.574493

Cited by 16 publications

(19 citation statements)

References 31 publications

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“…These findings highlight the benefits of administering low thoracic PCEA for postcesarean women who are more resistant to receiving rescue analgesics. Conversely, we observed unsatisfactory VAS profiles among participants in the other three groups at 24 h after surgery; this finding corresponds to those of previous studies [15,23,[31][32][33][34][35][36]. The dermatomes of a cesarean wound are located approximately between T10 and T12 [41] and uterine cramps are also transmitted through the visceral afferent nerves entering the spinal cord from T10 through L1 [12].…”

Section: Discussionsupporting

confidence: 88%

“…The efficacy of low thoracic PCEA for postcesarean pain relief had not been prospectively investigated prior to the present study. The incidence of moderate-or-severe postcesarean pain at 24 h after surgery is between 50% and 78.4% [15,31], and the highest reported VAS score is between 40 and 85 mm for various analgesia methods, excluding low thoracic PCEA [15,23,[32][33][34][35][36]. Furthermore, postpartum women are often reluctant to receive analgesics for fear of exposing their children to pain medication [2,37].…”

Section: Discussionmentioning

confidence: 99%

“…Nevertheless, we observed that relative to the other groups, the low thoracic PCEA group not only had a lower proportion of patients reporting a VAS of >33 mm; but also, these participants achieved a more favorable VAS score than did the other groups. In the present study, intravenous nalbuphine and tenoxicam were used institutionally because nalbuphine provides superior or comparable analgesic effects [36] to other opioids (such as sufentanil and morphine) but with fewer adverse effects [38]. In addition, intravenously administered nalbuphine efficiently ameliorates neuraxial opioid-induced pruritus without attenuating epidural analgesic effects [39].…”

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Influence of Catheter–Incision Congruency in Epidural Analgesia on Postcesarean Pain Management: A Single-Blinded Randomized Controlled Trial

Chen

Chou

Yie

et al. 2021

JPM

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Patient-controlled epidural analgesia (PCEA) or epidural morphine may alleviate postcesarean pain; however, conventional lumbar epidural insertion is catheter–incision incongruent for cesarean delivery. Methods: In total, 189 women who underwent cesarean delivery were randomly divided into four groups (low thoracic PCEA, lumbar PCEA, low thoracic morphine, and lumbar morphine groups) for postcesarean pain management. Pain intensities, including static pain, dynamic pain, and uterine cramp, were measured using a 100 mm visual analog scale (VAS). The proportion of participants who experienced dynamic wound pain with a VAS score of >33 mm was evaluated as the primary outcome. Adverse effects, including lower extremity blockade, pruritus, postoperative nausea and vomiting, sedation, and time of first passage of flatulence, were evaluated. Results: The low thoracic PCEA group had the lowest proportion of participants reporting dynamic pain at 6 h after spinal anesthesia (low thoracic PCEA, 28.8%; lumbar PCEA, 69.4%; low thoracic morphine, 67.3%; lumbar morphine group, 73.9%; p < 0.001). The aforementioned group also reported the most favorable VAS scores for static, dynamic, and uterine cramp pain during the first 24 h after surgery. Adverse effect profiles were similar among the four groups, but a higher proportion of participants in the lumbar PCEA group (approximately 20% more than in the other three groups) reported prolonged postoperative lower extremity motor blockade (p = 0.005). In addition, the first passage of flatulence after surgery reported by the low thoracic PCEA group was approximately 8 h earlier than that of the two morphine groups (p < 0.001). Conclusions: Epidural congruency is essential to PCEA for postcesarean pain. Low thoracic PCEA achieves favorable analgesic effects and may promote postoperative gastrointestinal recovery without additional adverse effects.

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Section: Discussionsupporting

confidence: 88%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Influence of Catheter–Incision Congruency in Epidural Analgesia on Postcesarean Pain Management: A Single-Blinded Randomized Controlled Trial

Chen

Chou

Yie

et al. 2021

JPM

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“…In the drug instructions for Nubain ® , nalbuphine is recommended to be administered every 3–6 h if necessary. Importantly, PCA is commonly used in clinical postoperative analgesia, and nalbuphine application via PCA had been reported in several reports 3,17–19 . However, differences in the pharmacokinetics of nalbuphine administered via single injection or PCA are still unclear.…”

Section: What Is Known and Objectivementioning

confidence: 99%

Pharmacokinetic comparison of nalbuphine with single injection and patient‐controlled analgesia mimic method in healthy Chinese volunteers

Zhao

et al. 2021

J Clin Pharm Ther

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What is known and objective Nalbuphine is a mu (μ) receptor partial antagonist/kappa (κ) receptor agonist analgesic and can be administered as a single injection or using patient‐controlled analgesia (PCA) in the clinical setting. However, differences in the pharmacokinetics of the two administration methods are unclear. Here, a clinical trial was performed to compare the pharmacokinetic characteristics and superiority of nalbuphine with a single‐injection or PCA‐mimic method to provide a reference for the selection of an appropriate administration method. Methods Twenty healthy individuals were divided into two groups and injected with 10 mg nalbuphine intravenously using a single‐injection or a PCA‐mimic method (2 mg once for five times with a 30‐min interval). Blood samples were collected, and safety was investigated. The liquid chromatography‐tandem mass spectrometry was adopted to determine the concentration of nalbuphine in plasma. Results and discussion The maximum concentration (Cmax) and area under concentration‐time curve (AUC0‐t) values of nalbuphine in the single‐injection and PCA groups were as follows: Cmax, 81.3 ± 24.7 and 39.8 ± 6.4 ng/ml, respectively; moreover, AUC0‐t, 110.3 ± 19.5 and 128.3 ± 23.0 h ng/ml, respectively. The effective analgesic concentration durations (EACDs) for the two administration methods were 1.39 ± 0.64 and 1.96 ± 0.91 h, respectively. Nalbuphine was well tolerated, and improvements were observed in the PCA group. What is new and conclusion Compared with those in the single‐injection group, the AUC0‐t and EACDs in the PCA group were similar, whereas Cmax was decreased significantly. Therefore, the PCA method was more suitable for the clinical application of nalbuphine injection owing to the superiority of lower concentration fluctuation and the improved safety profile.

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“…Nalbuphine, a synthesized partial κ-agonist/μ-antagonist opioid, is used to control mild-to-severe pain. Sun et al [ 9 ] and Xi et al [ 10 ] found that nalbuphine successfully controlled pain and may be a suitable alternative to sufentanil. Owing to κ-agonist actions, nalbuphine was more effective than μ-agonist opioids in visceral pain models [ 11 ].…”

Section: Introductionmentioning

confidence: 99%

Comparison of Analgesic Effects between Nalbuphine and Sufentanil in First-Trimester Surgical Abortion: A Randomized, Double-Blind, Controlled Trial

et al. 2021

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Introduction: Surgical abortion is one of the commonly conducted procedures worldwide. Nevertheless, pregnant women still complain of procedural and postoperative pain despite the use of advanced anesthesia. It is vital to women's reproductive healthcare to improve postsurgical pain management to achieve the lowest level of pain. Methods: This randomized, double-blind, parallel-controlled clinical trial compared the analgesic effects between nalbuphine and sufentanil in patients who underwent first-trimester surgical abortion. In total, 224 patients were allocated randomly into (a) the sufentanil group that received sufentanil (0.1 ug/kg) combined propofol, and (b) the nalbuphine group that received nalbuphine (0.1 mg/kg) combined propofol. Postoperative pain scores, propofol injection pain, intraoperative analgesic effect, adverse events, and degree of satisfaction were recorded as outcome measures. Results: The pain scores in the nalbuphine group were lower than those in the sufentanil group at 15 min, 30 min, 1 h, and 6 h after surgical abortion. In addition, the incidence and intensity of propofol injection pain were lower in the nalbuphine group. The degree of satisfaction of the patients in the nalbuphine group was higher than that in the sufentanil group. The intraoperative analgesic effect, hemodynamic fluctuation, and adverse events were comparable between the two groups. Conclusions: Nalbuphine combined with propofol is superior to sufentanil combined with propofol for first-trimester abortion surgeries. Clinical Trial Registration: The trial was registered at www.chictr.org.cn, identifier ChiCTR2000040243.

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Analgesic Effect Comparison Between Nalbuphine and Sufentanil for Patient-Controlled Intravenous Analgesia After Cesarean Section

Cited by 16 publications

References 31 publications

Influence of Catheter–Incision Congruency in Epidural Analgesia on Postcesarean Pain Management: A Single-Blinded Randomized Controlled Trial

Influence of Catheter–Incision Congruency in Epidural Analgesia on Postcesarean Pain Management: A Single-Blinded Randomized Controlled Trial

Pharmacokinetic comparison of nalbuphine with single injection and patient‐controlled analgesia mimic method in healthy Chinese volunteers

Comparison of Analgesic Effects between Nalbuphine and Sufentanil in First-Trimester Surgical Abortion: A Randomized, Double-Blind, Controlled Trial

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