Effect of nalbuphine on patient controlled intravenous analgesia after radical resection of colon cancer

Jiang, Qi; Zhang, Rongfang; Liu, Tao

doi:10.3892/ol.2020.11259

Cited by 6 publications

(5 citation statements)

References 21 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…27 This may be attributed to its central antagonist activity on μ-receptors. 28 Several studies have shown that the analgesic e cacy of nalbuphine is comparable to that of morphine, but nalbuphine provides a better safety pro le than morphine for PONV and pruritus, 29,30 which is consistent with our ndings.…”

Section: Discussionsupporting

confidence: 86%

Comparison of systemic morphine, nalbuphine, and epidural analgesia on acute and chronic postoperative pain in laparoscopic colorectal surgery: A randomized controlled trial

Jiang

Liang

Sun

et al. 2023

Preprint

View full text Add to dashboard Cite

Purpose: Postoperative pain and complications are still common after colorectal surgery, and pain can put patients in a stressful condition and precipitate complications. Thus, sufficient postoperative analgesia is essential for patient recovery. This study aimed to compare the efficacy of various postoperative analgesic strategies in laparoscopic colorectal surgery，and to elucidate whether systemic nalbuphine is a good choice for laparoscopic colorectal surgery. Patients and methods: One hundred patients undergoing laparoscopic colorectal cancer surgery were recruited, and 69 patients were eventually included and randomly divided into three groups: patient-controlled epidural analgesia (PCEA) with ropivacaine (Group R, n=23), patient-controlled intravenous analgesia (PCIA) with morphine (Group M, n=23) or nalbuphine (Group N, n=23). Pain at rest (PAR), movement-evoked pain (MEP), stress hormone and complications during the 72 hours after surgery, and chronic postsurgical pain (CPSP) at 3 months and 6 months were recorded. Results: There was no significant difference in PAR among the 3 groups, whereas patients in Group N had a higher intensity of MEP than those in Group R during the 72 hours after surgery (P<0.05). There was no significant difference in CPSP at 6 months among the 3 groups (P>0.05), but the incidence of CPSP at 3 months was higher in Group N (P=0.01, vs Group R), and CPSP at 3 months was closely correlated with MEP (P<0.05). There were no significant differences in cortisol and adrenocorticotropic hormone levels among the 3 groups (P>0.05). The incidences of pruritus and postoperative nausea and vomiting (PONV) were found to be significantly higher in Group M than in the other two groups (P<0.05). The time to the first flatus after surgery was shorter in Group R than in Group M or Group N (P<0.05). Conclusion: PCEA is the first choice for postoperative analgesia in laparoscopic colorectal surgery. Regarding the similar analgesic effect between morphine and nalbuphine, and the higher side effects from morphine, PCIA with nalbuphine might be a better choice in patients who have contraindications for PCEA or with a history of or a high risk for PONV or pruritus. Trial registration: This study was registered at http://www.chictr.org.cn/usercenter.aspx (registration No: ChiCTR-INR-17011092) on 08/04/2017.

show abstract

Section: Discussionsupporting

confidence: 86%

Comparison of systemic morphine, nalbuphine, and epidural analgesia on acute and chronic postoperative pain in laparoscopic colorectal surgery: A randomized controlled trial

Jiang

Liang

Sun

et al. 2023

Preprint

View full text Add to dashboard Cite

show abstract

“…19 This may be attributed to its central antagonist activity on μ-receptors. 28 Several studies have shown that the analgesic e cacy of nalbuphine is comparable to that of morphine, but nalbuphine provides a better safety pro le than morphine for PONV and pruritus, 29,30 which is consistent with our ndings.…”

Section: Discussionsupporting

confidence: 86%

Comparison of systemic morphine, nalbuphine, and epidural analgesia on acute and chronic postoperative pain in laparoscopic colorectal surgery: A randomized controlled trial

Jiang

Liang

Sun

et al. 2022

Preprint

View full text Add to dashboard Cite

Purpose Postoperative pain and complications are still common after colorectal surgery, and pain can put patients in a stressful condition and precipitate complications. Thus, sufficient postoperative analgesia is essential for patient recovery. This study aimed to compare the efficacy of various postoperative analgesic strategies in laparoscopic colorectal surgery. Patients and methods: One hundred patients undergoing laparoscopic colorectal cancer surgery were recruited, and 69 patients were eventually included and randomly divided into three groups: patient-controlled epidural analgesia (PCEA) with ropivacaine (Group R, n = 23), patient-controlled intravenous analgesia (PCIA) with morphine (Group M, n = 23) or nalbuphine (Group N, n = 23). Pain at rest (PAR), movement-evoked pain (MEP), stress hormone and complications during the 72 hours after surgery, and chronic postsurgical pain (CPSP) at 3 months and 6 months were recorded. Results There was no significant difference in PAR among the 3 groups, whereas patients in Group N had a higher intensity of MEP than those in Group R during the 72 hours after surgery (P < 0.05). There was no significant difference in CPSP at 6 months among the 3 groups (P > 0.05), but the incidence of CPSP at 3 months was higher in Group N (P = 0.01, vs Group R), and CPSP at 3 months was closely correlated with MEP (P < 0.05). There were no significant differences in cortisol and adrenocorticotropic hormone levels among the 3 groups (P > 0.05). The incidences of pruritus and postoperative nausea and vomiting (PONV) were found to be significantly higher in Group M than in the other two groups (P < 0.05). The time to the first flatus after surgery was shorter in Group R than in Group M or Group N (P < 0.05). Conclusion PCEA is the first choice for postoperative analgesia in laparoscopic colorectal surgery. Regarding the similar analgesic effect between morphine and nalbuphine, and the higher side effects from morphine, PCIA with nalbuphine might be a better choice in patients who have contraindications for PCEA or with a history of or a high risk for PONV or pruritus. Trial registration: This study was registered at http://www.chictr.org.cn/usercenter.aspx (registration No: ChiCTR-INR-17011092) on April 8, 2017.

show abstract

“…Nalbuphine is an opioid analgesic that was first manufactured in the 1970s and has been used to induce analgesia, similar to other opioids 1–3 . As a “neutral” mu (μ) receptor antagonist, nalbuphine induces various opioid‐related side effects, including pruritus, respiratory depression and urinary retention at low dose 4 .…”

Section: What Is Known and Objectivementioning

confidence: 99%

“…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

View full text Add to dashboard Cite

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.

show abstract

Effect of nalbuphine on patient controlled intravenous analgesia after radical resection of colon cancer

Abstract: Effect of nalbuphine on patient-controlled intravenous analgesia (PCIA) after radical resection of colon cancer was explored. Retrospective analyses of 100 patients who underwent elective laparoscopic radical resection of colon cancer in Xiang Yang No.

Cited by 6 publications

References 21 publications

Comparison of systemic morphine, nalbuphine, and epidural analgesia on acute and chronic postoperative pain in laparoscopic colorectal surgery: A randomized controlled trial

Comparison of systemic morphine, nalbuphine, and epidural analgesia on acute and chronic postoperative pain in laparoscopic colorectal surgery: A randomized controlled trial

Comparison of systemic morphine, nalbuphine, and epidural analgesia on acute and chronic postoperative pain in laparoscopic colorectal surgery: A randomized controlled trial

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

Contact Info

Product

Resources

About