Nalbuphine and butorphanol reverse opioid-induced respiratory depression but increase arousal in etorphine-immobilized goats (Capra hircus)

Haw, Anna; Meyer, Leith C. R.; Fuller, Andrea

doi:10.1111/vaa.12343

Cited by 12 publications

(9 citation statements)

References 21 publications

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“…Also, multiple butorphanol doses were required in the thiafentanil-medetomidine immobilised impalas to completely resolve apnoea. Similar to findings reported in etorphine-immobilised goats (Haw, Meyer & Fuller 2016 ), butorphanol, at the doses used, did not induce arousal from immobilisation but caused muscle relaxation in the goats and improved their breathing rate and rhythm.…”

Section: Discussionsupporting

confidence: 86%

Comparison of thiafentanil-medetomidine to etorphine-medetomidine immobilisation of impalas (<i>Aepyceros melampus</i>)

Zeiler

Meyer

2017

J. S. Afr. Vet. Assoc.

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Impalas (Aepyceros melampus) are increasingly valuable in the South African wildlife industry, and there is a greater need to chemically immobilise them, ideally with minimal risk. This study aimed to compare the times to recumbency and physiological effects of thiafentanil-medetomidine versus etorphine-medetomidine immobilisation. A combination of thiafentanil (2 mg) + medetomidine (2.2 mg) and etorphine (2 mg) + medetomidine (2.2 mg) was administered (to nine impalas; crossover design) via a dart. After darting, a stopwatch was started to record times to recumbency (time from darting until recumbent without attempts to stand). If apnoea was present, the impalas received one or more boluses of butorphanol (1:1 potent opioid dose). Data collection included arterial blood gas analysis and the number of butorphanol boluses. Two-sample t-tests were used to compare differences between combinations. The time to recumbency for thiafentanil-medetomidine was 12.2 (± 6.8) min and no different from 14.5 (± 5.2) min for etorphine-medetomidine (p = 0.426). The thiafentanil-medetomidine combination required more butorphanol boluses (median: 2; interquartile range: 2–3) compared to etorphine-medetomidine (median: 0; interquartile range: 0–1) (p = 0.001). Despite butorphanol treatment and resolution of apnoea, all impalas suffered hypoxaemia (PaO2 ± 44.0 mmHg). Thiafentanil-medetomidine did not immobilise impalas more rapidly than etorphine-medetomidine, and resulted in more apnoea that required rescue butorphanol boluses. Marked hypoxaemia resulted from both combinations, mainly because of right-to-left intrapulmonary shunting and not because of hypoventilation. Butorphanol and oxygen supplementation should be considered as essential rescue interventions for all impalas immobilised with these potent opioid combinations.

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Section: Discussionsupporting

confidence: 86%

Comparison of thiafentanil-medetomidine to etorphine-medetomidine immobilisation of impalas (<i>Aepyceros melampus</i>)

Zeiler

Meyer

2017

J. S. Afr. Vet. Assoc.

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“…Previous studies have demonstrated that effective and comprehensive postoperative analgesia does not only reduce postoperative pain in patients, but can also reduce the incidence of postoperative complications ( 3 ). The administration of nalbuphine, which does not affect circulatory function or increase the cardiac load ( 4 , 5 ), is commonly used for patients with hypertension and cardiac dysfunction ( 6 , 7 ). In the present study, we report the use of nalbuphine in the postoperative analgesic treatment of older patients with lower limb fractures after open reduction and internal fixation.…”

Section: Introductionmentioning

confidence: 99%

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

2017

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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.

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“…Naborphine, as a new type of synthetic opioid, has emerged its clinical value in recent years. Nalbuphine is a powerful analgesic showing low side effects and low dependence in animals and humans, and it has been shown to be effective against the respiratory inhibitory without attenuation of analgesia ( Klepper et al, 1986 ; Narver, 2015 ; Haw et al, 2016 ). Previous studies have confirmed that combination of dexmedetomidine and sufentanil on spinal anesthesia ( Karimi et al, 2021 ) or nalbuphine combined with dexmedetomidine in the postoperative treatment of laparoscopic oophorocystectomy ( Liu et al, 2021 ) achieved good clinical effects such as longer postoperative analgesia, reduced use of analgesic, and slight hemodynamic changes.…”

Section: Discussionmentioning

confidence: 99%

Analgesic Effects and Safety of Dexmedetomidine Added to Nalbuphine or Sufentanil Patient-Controlled Intravenous Analgesia for Children After Tonsillectomy Adenoidectomy

Jia

Wang

et al. 2022

Front. Pharmacol.

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Tonsillectomy is a frequently performed surgical procedure in children, requiring post-operative analgesia. This study evaluated the efficacy and safety of nalbuphine or sufentanil combined with dexmedetomidine for patient-controlled intravenous analgesia (PCIA) after pediatric tonsillectomy adenoidectomy. A total of 400 patients undergoing tonsillectomy with and without adenoidectomy were included in the study. Patients received a PCIA pump (0.5 mg/kg nalbuphine, 2 μg/kg dexmedetomidine and 0.9% sodium chloride to a total volume of 100 ml) for postoperative pain management were classified into Group ND (n = 200). Patients received a PCIA pump (2 μg/kg sufentanil, 2 μg/kg dexmedetomidine and 0.9% sodium chloride to a total volume of 100 ml) for postoperative pain management were classified into Group SD (n = 200). More stable hemodynamic changes were noted in Group ND than Group SD from 1 h to 48 h after operation. At 6, 12, 24, and 48 h after operation, the children in Group ND had higher Ramsay sedation scores than those in Group SD. The times to push the PCIA button in Group ND and Group SD were 2.44 ± 0.74 and 2.62 ± 1.00, showing significant differences (p = 0.041). The VASR scores of children in Group ND were significantly lower within 6, 12, and 24 h than those in Group SD (p < 0.05). The VASC scores of children in Group ND were significantly lower within four time points (2, 6, 12, and 24 h) than those in Group SD (p < 0.05). At 1st day after surgery, the children in Group ND had lower levels of serum ACTH, IL-6, and COR levels than those in Group SD (p < 0.001). The incidence rates of nausea and vomiting, and pruritus were significantly higher in Group SD than Group ND (5.00% vs. 11.00%, p = 0.028; 1.00% vs. 4.50%, p = 0.032). The total incidence rate of adverse reactions was significantly higher in Group SD than Group ND (15.00% vs. 31.00%, p = 0.0001). The study demonstrated that dexmedetomidine added to nalbuphine PCIA enhanced the analgesic effects, attenuated the postoperative pain, and reduced the stress response after pediatric tonsillectomy adenoidectomy.

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Nalbuphine and butorphanol reverse opioid-induced respiratory depression but increase arousal in etorphine-immobilized goats (Capra hircus)

Cited by 12 publications

References 21 publications

Comparison of thiafentanil-medetomidine to etorphine-medetomidine immobilisation of impalas (<i>Aepyceros melampus</i>)

Comparison of thiafentanil-medetomidine to etorphine-medetomidine immobilisation of impalas (<i>Aepyceros melampus</i>)

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

Analgesic Effects and Safety of Dexmedetomidine Added to Nalbuphine or Sufentanil Patient-Controlled Intravenous Analgesia for Children After Tonsillectomy Adenoidectomy

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