Nalbuphine as an adjuvant to 0.25% levobupivacaine in ultrasound-guided supraclavicular block provided prolonged sensory block and similar motor block durations (RCT)

Abdelhamid, Bassant Mohamed; Omar, Heba

doi:10.1007/s00540-018-2512-x

Cited by 12 publications

(24 citation statements)

References 36 publications

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“…Both nalbuphine and ketorolac infiltration prolonged the duration of analgesia and reduced the additional rescue analgesia rates and the postoperative consumption of morphine. As reported for other peripheral nerve blocks, our results show that nalbuphine and ketorolac infiltration have a postoperative opioid-sparing effect [10,16]. In addition, postoperative NRS pain scores within 12 h were lower in both the nalbuphine and the ketorolac infiltration groups compared with the ropivacaine alone group.…”

Section: Discussionsupporting

confidence: 85%

“…Nalbuphine, a mixed agonist-antagonist opioid, was found to prolong the duration of analgesia in supraclavicular brachial block, subarachnoid block and epidural block as an adjuvant to local anesthetics. To the best of our knowledge, this aspect of nalbuphine infiltration has not been previously investigated [9][10][11] [3].…”

Section: Discussionmentioning

confidence: 99%

“…Opioids and NSAIDs are the two most essential analgesics. The analgesic effects of both opioids (nalbuphine) [9][10][11] and NSAIDs (ketorolac) [12][13][14] as local anesthetic adjuvants in various nerve blocks are well established compared with placebo. With regard to LWI, there is high-quality evidence that ketorolac 30-60 mg may be an effective infiltration agent, with peripheral analgesia beyond the effects of systemic absorption [3,15,16].…”

Section: Introductionmentioning

confidence: 99%

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Nalbuphine Versus Ketorolac as an Adjuvant to Local Wound Infiltration Anesthesia in Open Colorectal Surgery: A Prospective Randomized Controlled Study

Ren

Wang

et al. 2021

Pain Ther

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Introduction: Adding adjuvants to local wound infiltration (LWI) provides long analgesic duration with fewer adverse effects. We aimed to compare the clinical effects of nalbuphine and ketorolac as an adjuvant to LWI in patients undergoing open colorectal cancer surgery. Method: A total of 126 ASA I-III patients aged C 18 years who were scheduled for open colorectal cancer surgery were included. Patients were randomly assigned to receive LWI using 10 mL 0.75% ropivacaine, with 20 mL normal saline (group R), 10 mg nalbuphine in 1 mL (group RN), or 25 mg ketorolac in 0.8 mL (group RK). Analgesia duration was the primary outcome. The total 48-h postoperative morphine-equivalent consumption and additional rescue analgesia rates were recorded as key secondary outcomes. Results: Among 126 patients randomized, 124 completed the trial. The duration until the first press of the analgesia pump was significantly shorter in group R (median: 320.0 min) compared with group RN (median: 829.5 min) and group RK (median: 820.0 min) (P \ 0.001). The median difference in morphine consumption was 113.0 mg for group R vs. group RN (P \ 0.001), and 115.5 mg for group R vs. group RK (P \ 0.001). The proportion of patients using additional morphine within the first day after surgery in group R showed a higher relative risk (RR) compared with group RN (RR, 3.89; P = 0.001) and group RK (RR, 3.17; P = 0.001). There were no apparent differences between the RN and RK groups in any outcomes, whether in adjusted or unadjusted analysis. Conclusions: Among patients undergoing open colorectal cancer surgery, both nalbuphine and ketorolac infiltration achieved equally prolonged duration of analgesia and reduced morphine consumption compared with ropivacaine alone after surgery, suggesting that the equivalent analgesic dose of nalbuphine and ketorolac as local anesthetic adjuvants in LWI could have a similar analgesic effect. Trial Registration: ChiCTR1800019209.Yi-Feng Ren and Xi Fu have contributed equally as cofirst authors.

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Section: Discussionsupporting

confidence: 85%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Nalbuphine Versus Ketorolac as an Adjuvant to Local Wound Infiltration Anesthesia in Open Colorectal Surgery: A Prospective Randomized Controlled Study

Ren

Wang

et al. 2021

Pain Ther

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“…There were no differences in the incidences of nausea and vomiting among groups, but three patients in the R + HN group experienced nausea after surgery and two of them experienced vomiting. Prior studies have shown that nalbuphine added to ropivacaine or levobupivacaine prolonged the duration of sensory block and motor block in upper limb surgery [ 15 , 31 ]. Rao et al.…”

Section: Discussionmentioning

confidence: 99%

Effect of Ultrasound-Guided Fascia Iliac Compartment Block with Nalbuphine and Ropivacaine on Preoperative Pain in Older Patients with Hip Fractures: A Multicenter, Triple-Blinded, Randomized, Controlled Trial

et al. 2022

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Introduction Pain management for older patients with hip fractures is challenging. This study aimed to investigate the effect of ultrasound-guided fascia iliac compartment block (UGFICB) using different doses of nalbuphine in combination with ropivacaine on preoperative analgesia in older patients with hip fractures. Methods In this multicenter randomized controlled trial, 280 elderly patients with hip fracture were randomly allocated into four UGFICB groups ( n = 70 in each group): a ropivacaine group (30 mL 0.1% ropivacaine + 0.9% normal saline) and three ropivacaine plus nalbuphine groups (5, 10, and 20 mg nalbuphine, respectively). The primary outcomes were the duration of analgesia at rest and on passive movement. Secondary outcomes included sensory block area, side effects, and vital signs. The doses of rescue analgesia with parecoxib sodium were also analyzed. Results The addition of nalbuphine dose-dependently increased the duration of analgesia at rest and on passive movement ( P < 0.05) and expanded the area of sensory block ( P < 0.05). Compared with the ropivacaine group, the pain scores at rest and on movement at 6 and 8 h after the block were lower in three ropivacaine plus nalbuphine groups ( P < 0.05), without between-group differences at 2, 4, and 12 h. The four groups had comparable side effects (nausea and vomiting) and vital signs ( P > 0.05). Conclusions UGFICB with 5, 10, and 20 mg nalbuphine added to ropivacaine prolonged the analgesia duration, increased sensory block area, reduced pain, and decreased the doses of rescue parecoxib sodium for older patients after hip fracture, without obvious side effects. Among these three doses, nalbuphine 20 mg in combination with ropivacaine provided the longest duration of analgesia and the largest sensory block area. Trial Registration Chinese Clinical Trial Registry (ChiCTR2000029934).

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“…All the data were statistically analyzed by Statistical Package for the Social Sciences (SPSS) 19.0 software, the counting data were analyzed by X 2 test, the mean±standard deviation (x ̅ ±s) as used to represent the measurement data, the T test was used to compare the two groups of measurement data, and the analysis of variance was used to compare the multi group measurement data. commonly used drugs for preemptive analgesia [1] . Hydromorphinone hydrochloride is a semisynthetic opioid, a derivative of morphine, which plays an analgesic effect by activating opioid receptors in the central nervous system.…”

mentioning

confidence: 99%

Clinical Study of Preemptive Analgesia with Hydromorphine on Postoperative Analgesia in Patients with Laparoscopic Hysterectomy

Lian¹,

Yin²,

Li³

et al. 2021

ijps

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Pain after laparoscopic hysterectomy can lead to strong stress response, increase blood pressure and heart rate, restless during the awakening period. Preemptive analgesia is one of the methods to relieve postoperative pain. The purpose of this study is to explore the feasibility and safety of hydromorphine hydrochloride in preemptive analgesia, and to provide reference for clinical application. Two hundred American Society of Anesthesiologists I-II patients undergoing laparoscopic hysterectomy under endotracheal intubation general anesthesia from September 2019 to October 2020 were randomly divided into observation group (n=100) and control group (n=100) according to random number table. Patients in both groups were given intravenous rapid induction tracheal intubation combined with general anesthesia. 15 min before skin incision, hydromorphinone hydrochloride 15 µg/kg (diluted to 10 ml with normal saline) was injected intravenously in the observation group, while normal saline 10 ml was injected into the control group. Visual analogue score was used to evaluate the analgesic effect after tracheal extubation. Venous blood samples were taken 5 min before anesthesia and after extubation, and the levels of plasma epinephrine, norepinephrine and dopamine were measured. The mean arterial pressure and heart rate of the two groups were recorded before anesthesia, after operation, immediately after extubation, 10 min after extubation and 30 min after extubation. Ramsay sedation scale was used to evaluate the sedation of patients with 10 min, 30 min and 1 h after endotracheal tube extubation. Riker Sedation-Agitation Scale was used to observe the occurrence of restlessness in the recovery period within 24 h after operation. There was no significant difference in basic characteristics between the two groups (p>0.05). Visual analogue score: compared with the control group, the visual analogue scores at 10 min after extubation, 30 min after extubation, 1 h, 2 h, 4 h, 6 h and 12 h after endotracheal tube extubation in the observation group were significantly lower than those in the control group. There was no significant difference in the levels of plasma epinephrine, norepinephrine and dopamine between the two groups before anesthesia. After extubation, the levels of plasma epinephrine, norepinephrine and dopamine in the 5 min control group were significantly higher than those in the observation group (p<0.05). Hemodynamics (mean arterial pressure and heart rate in the control group were significantly higher than those in the observation group after operation, immediately after extubation, 10 min after extubation and 30 min after extubation in mean arterial pressure and heart rate): groups, and the difference was statistically significant. There was no significant difference in spontaneous respiratory recovery time and extubation time between the two groups (p>0.05). Ramsay sedation score: there was no difference between the two groups. Preemptive analgesia with hydromorphine hydrochloride in patients undergoing laparoscopi...

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Nalbuphine as an adjuvant to 0.25% levobupivacaine in ultrasound-guided supraclavicular block provided prolonged sensory block and similar motor block durations (RCT)

Abstract: Adding 20 mg nalbuphine to 25 ml of 0.25% levobupivacaine in supraclavicular block provided prolonged duration of sensory block with similar duration of motor block.

Cited by 12 publications

References 36 publications

Nalbuphine Versus Ketorolac as an Adjuvant to Local Wound Infiltration Anesthesia in Open Colorectal Surgery: A Prospective Randomized Controlled Study

Nalbuphine Versus Ketorolac as an Adjuvant to Local Wound Infiltration Anesthesia in Open Colorectal Surgery: A Prospective Randomized Controlled Study

Effect of Ultrasound-Guided Fascia Iliac Compartment Block with Nalbuphine and Ropivacaine on Preoperative Pain in Older Patients with Hip Fractures: A Multicenter, Triple-Blinded, Randomized, Controlled Trial

Clinical Study of Preemptive Analgesia with Hydromorphine on Postoperative Analgesia in Patients with Laparoscopic Hysterectomy

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