Equal volumes of undiluted nalbuphine and lidocaine and normal diluted saline prevents nalbuphine-induced injection pain

Wang, Fuy Uan; Shen, Ya Chun; Chen, Mao Kai; Chau, Siu Wah; Ku, Chia Ling; Feng, Yu Tung; Cheng, Kuang Hung

doi:10.1016/j.aat.2011.11.009

Cited by 5 publications

(7 citation statements)

References 26 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Thus, nalbuphine administration can, not only achieve analgesia but also inhibits adverse reactions caused by activated µ receptors ( 16 ). Finally, nalbuphine can also increase opioid receptor density and activity ( 17 , 18 ), which in turn improves the analgesic effect and induces sedation ( 19 , 20 ). Our results, demonstrating the superiority of the nalbuphine analgesia over that of sufentanil can all be explained by these reported characteristics.…”

Section: Discussionmentioning

confidence: 99%

Nalbuphine for analgesia after fracture surgery and its effect on circulating inflammatory factors

2017

View full text Add to dashboard Cite

The present study evaluated the use of nalbuphine for analgesia after fraction reduction surgery. Eighty lower limb fracture patients needing open reduction and internal fixation were selected in the First People's Hospital of Jingzhou from January 2015 to December 2015. Patients were randomly divided into observation and control groups (with 40 cases in each). After surgery, the patients in the observation group were treated with nalbuphine (2 mg/kg) for patient-controlled intravenous analgesia (PCIA), while sufentanil (2.5 µg/kg) was used for patients in the control group. The analgesia treatment lasted for 48 h after surgery. Changes in inflammatory factors and catecholamine hormones during the observation period were determined and compared between the groups. Pain, sedation scores and the number of times the analgesia pump was used were recorded at different time-points. Additionally, the life and sleep qualities and any adverse reactions were also recorded. Our results showed that after the operation, the levels of interleukin-6 (IL-6), tumor necrosis factor-α (TNF-α), interleukin-1 (IL-1), high-sensitivity CRP (hs-CRP) cortisol, adrenaline epinephrine (AD) and norepinephrine (NE) were significantly lower in the observation group than in the control group (P<0.05). Pain and sedation scores of patients in the observation group were better than those in the control group at all time-points after operation (P<0.05). Life and sleep qualities of patients in the observation group were also better than those in the control group (P<0.05). Finally, the rates of nausea, vomiting, dizziness, lethargy, urinary retention, skin itch and constipation were significantly lower in the observation group than in control group (P<0.05). Based on our findings, the application of nalbuphine for analgesia in patients with fracture surgeries can reduce the levels of inflammatory cytokines, improve the analgesic effect, bring beneficial sedative effects and reduce the occurrence of adverse reactions.

show abstract

Section: Discussionmentioning

confidence: 99%

Nalbuphine for analgesia after fracture surgery and its effect on circulating inflammatory factors

2017

View full text Add to dashboard Cite

show abstract

“…A combination of various adjuvant agents with morphine in the PCA regimen reduces the dose of morphine and therefore decreases the incidence and severity of morphine‐related side effects. Nalbuphine is a mixed kappa opioid agonist and mu opioid antagonist which possesses and restores the analgesic properties of morphine while inhibiting the action of morphine on mu opioid receptor‐induced side effects at the same time when it is coadministered with morphine [6–9]. In addition, nalbuphine is superior to naloxone for the treatment of side effects after epidural morphine administration [10].…”

Section: Introductionmentioning

confidence: 99%

Dose‐dependent attenuation of intravenous nalbuphine on epidural morphine‐induced pruritus and analgesia after cesarean delivery

Chen

Chau

Shen

et al. 2014

The Kaohsiung J of Med Scie

View full text Add to dashboard Cite

Epidural morphine in patient-controlled analgesia regimens controls postoperative pain well but easily induces pruritus and other epidural morphine-related side effects. With 90 pregnant American Society of Anesthesiologists physical status II females scheduled for elective cesarean delivery, the present study was designed to evaluate the efficacy and safety profile of patient-controlled antipruritus (PCP) use of intravenous nalbuphine-based regimens for attenuation of postoperative pruritus and related side effects in combination with epidural morphine patient-controlled analgesia with regard to the quality of postoperative pain management. Patients were randomly assigned to two nalbuphine groups (5 μg/kg/hour, Group N5 or 10 μg/kg/hour, Group N10) and bolus dose of 1.6 μg/kg for PCP or the control (normal saline) group. Comparable visual analog scale scores for rest pain at each measured time interval among the three groups demonstrated that adequate pain relief was offered; however, the cumulative dose of nalbuphine administered to the patients in Group N10 attenuated the analgesic effect of epidural morphine in moving pain at POh24 only. Fewer episodes and milder severity of pruritus were observed in patients in Groups N5 and N10 at all postoperative time intervals. Epidural morphine provided good postoperative pain relief but with incommodious side effects. In addition, intravenous nalbuphine not only attenuated the incidence of pruritus but also decreased total morphine consumption. In conclusion, intravenous administration of low-dose nalbuphine (5 μg/kg/hour) for PCP maintained analgesia produced by epidural morphine and offered low pruritus incidence.

show abstract

“…For the MMA protocol, in this case, we included extendedreleased DS intramuscular injection before the operation, ultrasound-guided TAP at the end of the surgery, and other pain medications: ketamine, dexamethasone, acetaminophen, and ketorolac for opioid-sparing effect (Alvarez et al, 2014;Remérand et al, 2009;Brinck et al, 2018;Wang et al, 2011;DREAMS Trial Collaborators and West Midlands Research Collaborative, 2017;Tolska et al, 2019). We observed sufficient pain relief without the requirement of other pain medications after discharge.…”

Section: Discussionmentioning

confidence: 97%

“…Rocuronium 60 mg was used to facilitate endotracheal intubation with a 7.5 mm inner diameter. Ketamine 50 mg (Remérand et al, 2009;Brinck et al, 2018) and dexamethasone 10 mg (Wang et al, 2011;DREAMS Trial Collaborators and West Midlands Research Collaborative, 2017;Brown et al, 2018) were also given for preemptive analgesia and postoperative nausea and vomiting (PONV) prevention respectively. After the anesthesia induction setup, the patient was placed in a supine position and received one dose of longacting dinalbuphine sebacate (150 mg DS/2ml, Naldebain ® ER Injection, Lumosa Therapeutics Co. Ltd., Taiwan) by ultrasoundguided intramuscular injection at the left upper arm.…”

Section: Case Reportmentioning

confidence: 99%

Multimodal Analgesia With Long-Acting Dinalbuphine Sebacate Plus Transversus Abdominis Plane Block for Perioperative Pain Management in Bariatric Surgery: A Case Report

Liu

Wong

2021

Front. Pharmacol.

View full text Add to dashboard Cite

Laparoscopic bariatric surgery is increasingly performed in morbidly obese patients. However, post-surgical pain is common and is usually managed with classical opioids such as morphine and fentanyl. Further, morbidly obese patients are predisposed to opioid-related side effects, especially post-operative nausea and vomiting (PONV), and respiratory depression. Obstructive sleep apnea in morbidly obese patients even predisposes them to respiratory depression. Thus, reducing opioid consumption is important. Multimodal analgesia (MMA) provides optimal perioperative analgesia while minimizing opioid consumption. Studies have shown that MMA strategy can provide sufficient pain relief in bariatric surgery with enhanced recovery. There are very few reports on the use of dinalbuphine sebacate (DS), a newly introduced non-controlled opioid medication with long-lasting analgesic effects. DS has a different mechanism of action from that of morphine or fentanyl and is non-addictive, with minimal side effects. It has been successfully used in laparoscopic cholecystectomy in our previous study. We present a case of a new MMA protocol with DS on a 46-year-old morbidly obese female patient who underwent laparoscopic sleeve gastrectomy. The MMA protocol included ultrasound-guided intramuscular DS injection plus transversus abdominis plane (TAP) block and other analgesics; it achieved good perioperative analgesia with opioid-sparing effect and enhanced patient’s recovery with no pain in the following 4 months.

show abstract

Equal volumes of undiluted nalbuphine and lidocaine and normal diluted saline prevents nalbuphine-induced injection pain

Abstract: A solution of equal volumes of lidocaine and nalbuphine can decrease intravenous nalbuphine-induced injection pain.

Cited by 5 publications

References 26 publications

Nalbuphine for analgesia after fracture surgery and its effect on circulating inflammatory factors

Nalbuphine for analgesia after fracture surgery and its effect on circulating inflammatory factors

Dose‐dependent attenuation of intravenous nalbuphine on epidural morphine‐induced pruritus and analgesia after cesarean delivery

Multimodal Analgesia With Long-Acting Dinalbuphine Sebacate Plus Transversus Abdominis Plane Block for Perioperative Pain Management in Bariatric Surgery: A Case Report

Contact Info

Product

Resources

About