Cardiorespiratory Effects of Nalbuphine and Morphine Premedication in Adult Cardiac Surgical Patients

Abstract

Premedication for cardiac surgical patients attempts to achieve relief of anxiety with minimal or no cardiorespiratory changes. Nalbuphine (NUBAIN) and morphine produced similar decreases in respiratory rate (1-3 breaths per min) and PaO2 (averaging 1.34 kPa), and increases in arterial PaCO2 (averaging 0.56 kPa). Cardiovascular changes were not seen with either agent. A similar degree of sedation and relief of anxiety was achieved with both drugs. Side effects were minimal and infrequent. Nalbuphine produces respiratory depression and sedation without cardiovascular changes which is comparable to an equivalent dose of morphine in patients with either valvular or coronary artery disease.

Perineural nalbuphine in ambulatory upper limb surgery: A comparison of effects of levobupivacaine with and without nalbuphine as adjuvant in supraclavicular brachial plexus block – A prospective, double-blinded, randomizedcontrolled study

“…[14] Nalbuphine has the onset of action between 2 and 3 min, duration of action of 3–6 h with cardiovascular stability, and minimal side effects in the dose of 0.2–0.4 mg/kg. [1315] Because of its safety profile, nalbuphine can be used for pain management in children with burns, neoplastic or hematological diseases. [16] Freedom from controlled drug act regulations and improved analgesia with nalbuphine render it more satisfactory for day care surgery than other commonly used opioids.…”

What Parenteral Opioids to Use in Face of Shortages of Morphine, Hydromorphone, and Fentanyl

“…16,17 Nalbuphine does not cause hypotension, reduce cardiac output, and prolong the QTc interval and is safe to give in the case of acute myocardial infarction. [18][19][20] It is a preferred opioid in cardiovascular disease and is an excellent analgesic to use in the intensive care unit when patients are on vasopressor medications. Nalbuphine has a ceiling on respiratory depression similar to buprenorphine.…”

Comparison of acetaminophen and nalbuphine in attenuating hemodynamic response to tracheal intubation.

“…There are minimal side effects in the dose of 0.2-0.4mg/ kg and no deleterious effects on cardiovascular stability. [4][5][6] Another analgesic drug which is easily available is acetaminophen (paracetamol). Paracetamol has a well-established safety and analgesic profile.…”

“…4 Nalbuphine, an ideal analgesic for use in balanced anesthesia because of its beneficial effects on cardiovascular stability and potential safety in over-dosage, which causes adverse effects like nausea, vomiting and at times respiratory depression. 5,6 Acetaminophen (Paracetamol) has been successfully used for management of postoperative pain in different types of operations. 7,8 Studies conducted in the past to assess the efficacy of acetaminophen in attenuating the DOI: 10.29309/TPMJ/2020.27.…”