Multimodal Analgesia with Extended-Release Dinalbuphine Sebacate for Perioperative Pain Management in Upper Extremity Trauma Surgery: A Retrospective Comparative Study

Abstract

Introduction:Patients undergoing upper extremity fracture surgery (UEFS) commonly suffer from unbearable acute pain. Opioids remain the mainstay of moderate to severe pain alleviation, although there is a growing concern regarding the increasing trend in misuse and abuse. This study aimed to observe the safety and efficacy of dinalbuphine sebacate (DS), a novel extended-release analgesic, along with multimodal analgesia (MMA) for post-UEFS pain control.Methods: We retrospectively reviewed the records of patients undergoing UEFS between August 2020 and January 2021. Eligible patients were included and divided into two groups, depending on the analgesic regimen. In the DS group, 150 mg DS was administered intramuscularly at least 12 h pre-operatively, while in the conventional analgesia (CA) group, 40 mg parecoxib was given within 3 h before surgery. Intraoperative fentanyl administration was guided by the Analgesia Nociception Index System in both groups. For breakthrough pain, fentanyl was used as rescue medicine in the

Novel Opioids in the Setting of Acute Postoperative Pain: A Narrative Review

“…Additionally, DNS led to significantly faster ambulation [ 90 ]. Another retrospective study by Zheng et al examining the efficacy of DNS as part of a multimodal analgesia regimen (parecoxib, acetaminophen, and celecoxib) in upper extremity trauma surgery showed that the proportion of patients requiring opioids for postoperative breakthrough pain was significantly lower in those treated with DNS [ 91 ]. Finally, Lee et al found that there was no statistically significant difference in pain scores when comparing preoperative DNS to postoperative morphine in a randomized study of 43 patients following laparoscopic cholecystectomy [ 92 ].…”

Subjective Assessments and Serum Cortisol Levels as Risk Factors of Pain Persistence in the Late Postoperative Period in Old and Oldest-Old Patients

“…Evidence suggests that between 35% and 70% of patients who have undergone elective and emergency surgery suffer from postoperative pain. In one of the largest studies of patients in surgical departments in the UK, it was found that 10.9 percent of patients experienced high-intensity postoperative pain, while 29.7 percent of patients experienced medium-intensity pain [1].…”

Breast Milk Excretion of Dinalbuphine Sebacate Injection Administered After Cesarean Section

“…6 In addition, the feasibility of dinalbuphine sebacate injection integrated with postoperative multimodal analgesia was also fully demonstrated in several abdominal and orthopedic surgeries. [7][8][9] However, the amount of nalbuphine or dinalbuphine sebacate excreted in breast milk and its potential impact on breastfed infants are not well understood. Current risk and benefit evaluation is based on limited data for nursing mothers receiving nalbuphine injections.…”

“…While its safety and efficacy have been established in the previous pivotal study in patients undergoing hemorrhoidectomy, the analgesic effect can last for approximately 7 days, and it has a tolerable safety profile 6 . In addition, the feasibility of dinalbuphine sebacate injection integrated with postoperative multimodal analgesia was also fully demonstrated in several abdominal and orthopedic surgeries 7–9 . However, the amount of nalbuphine or dinalbuphine sebacate excreted in breast milk and its potential impact on breastfed infants are not well understood.…”