Influences of Gender on Intravenous Nalbuphine Actions After Major Abdominal Surgery: A Multicenter Study

Abstract

Introduction: Nalbuphine, a synthetic kappaopioid receptor (KOR) agonist and a partial lopioid receptor (MOR) antagonist, has been used for years as an effective analgesic. It has been shown to have a better safety profile than morphine. Considering the long history of use of this drug, it is interesting that only a limited amount of information exists on how gender

Letter to the Editor regarding “Influences of Gender on Intravenous Nalbuphine Actions After Major Abdominal Surgery: A Multicenter Study”

“…In a randomized double-blind comparative trial including 64 male and 63 female patients undergoing major abdominal surgery, Ayad et al [ 1 ] evaluated the influences of gender on postoperative analgesic efficacy of continuous intravenous nalbuphine with two different dosages. They showed that females were more sensitive than males to the analgesic effects of nalbuphine.…”

A Response to: Letter to the Editor regarding “Influences of Gender on Intravenous Nalbuphine Actions After Major Abdominal Surgery: A Multicenter Study”

“…Finally, regarding the fourth comment, which related to adverse events (AEs), the AEs associated with nalbuphine are slightly different from those associated with other l-opioid receptor (MOR) agonists, as nalbuphine is a j-receptor agonist and a partial MOR antagonist. The AEs registered in the study of Ayad et al [1] reflect this difference, with more sedation, nausea, and vomiting events but much less respiratory depression and pruritus observed [8]. Although this study was not sufficiently powered to quantitatively assess any single type of AE, there was a significant higher incidence of AEsmostly sedation, nausea, and vomiting-in females, as reported in Table 3 of Ayad et al [1], which is in agreement with the side effects most commonly encountered with nalbuphine use [8].…”

“…The AEs registered in the study of Ayad et al [1] reflect this difference, with more sedation, nausea, and vomiting events but much less respiratory depression and pruritus observed [8]. Although this study was not sufficiently powered to quantitatively assess any single type of AE, there was a significant higher incidence of AEsmostly sedation, nausea, and vomiting-in females, as reported in Table 3 of Ayad et al [1], which is in agreement with the side effects most commonly encountered with nalbuphine use [8]. In our study, this gender difference was clinically noticed for a dose of 2 mg/h and both clinically and statistically noticed for a dose of 1 mg/h.…”

“…Thank you for informing us about the letter criticizing our recently published research results [ 1 ]. Also, we would like to thank Professor F.S.…”

“…However, for the benefit of the readers, Tables 1 and 2 of this reply list the data already presented in Figs. 2 and 3 of the publication of interest [ 1 ], with standard deviations included.…”