Nalbuphine on postoperative gastrointestinal tract dysfunction after laparoscopic surgery for gynaecological malignancies: A randomized controlled trial

Abstract

Background The aim of this study was to compare the effects of nalbuphine and sufentanil on the gastrointestinal (GI) tract after laparoscopic surgery for gynecological malignancies. Methods A total of 100 patients aged between 18-70 years with American Society of Anesthesiologists (ASA) physical status I-II who scheduled for laparoscopic radical hysterectomy under general anaesthesia were enrolled. Patients were randomized to receive either sufentanil (Group S) or nalbuphine (Group N) to receive either sufentanil (Group S) or nalbuphine (Group N) in the intraoperative and postoperative periods. The time to the first passage of flatus, the time to the first defecation, the time to the toleration of diet, the serum gastrin and the length of hospital stay were compared between the groups. Postoperative pain by visual analogue scale (VAS), the number of PCA(patient-controlled analgesia)s, postoperative nausea and vomiting, and dizziness were compared between the groups. Results The time to the first passage of flatus(p =0.551), the time to the first defecation(p =0.310), the time to the toleration of diet(p =0.182), the serum gastrin(p =0.397), the number of postoperative nausea(p =0.920), vomit(p =0.334) and PCA events(p =0.167) and the length of hospital stay(p =0.482) were not significantly different between the two groups. VAS scores at postoperative 6 h(p=0.008), 12 h(p =0.002) and 24 h(p =0.013) were lower in Group N than in Group S. Conclusions Compared with sufentanil, nalbuphine was not associated with improved postoperative GI dysfunction after laparoscopic surgery for gynecological malignancies, but it was associated with reduced postoperative pain. Background Postoperative gastrointestinal (GI) dysfunction such as nausea, vomiting, inability to eat, deflation, prolonged bowel movements, and paralytic ileus are some of the most common complications after surgery, and the incidence is nearly 10-30%(1). The occurrence of postoperative GI dysfunction leads

Pharmacokinetic comparison of nalbuphine with single injection and patient‐controlled analgesia mimic method in healthy Chinese volunteers

“…Moreover, because nalbuphine has very weak reactivity with delta (δ) receptors, this drug is expected to cause reduced irritability or anxiety 5,6 . In the clinical setting, pretreatment with nalbuphine can effectively reduce propofol‐induced injection pain and propofol consumption as well as ameliorate postoperative hyperalgesia induced by high‐dose remifentanil or sufentanil 7–9 . Nalbuphine exhibits a higher therapeutic index owing to its reduced incidence of adverse events (AEs), but has analgesic effects similar to those of morphine 10 .…”

Effects of Nalbuphine on Gastrointestinal Function in Post-Operative Critical Ill Patients Admitted to the ICU: A Multicenter Randomized Controlled Trial

“…The limitations in our study may cover the real outcome. However, recent studies suggested that nalbuphine did not shorten the time to the first flatus or the first defecation compared with sufentanil in patients after laparoscopic surgery for gynecological malignancies ( 25 ). Moreover, nalbuphine did not produce a worthwhile improvement in gastric emptying compared with pethidine in patients following the laparoscopic sterilization ( 26 ).…”

Nalbuphine alleviates inflammation by down-regulating NF-κB in an acute inflammatory visceral pain rat model

“…Compared with μ-opioid receptor agonists such as remifentanil, sufentanil, and fentanyl, nalbuphine is a kappa-opioid receptor agonist and μ-opioid receptor antagonist with fewer side effects and a higher safety profile [ 9 , 10 ]. Nalbuphine is structurally similar to naloxone, mainly used in clinical practice for intraoperative and postoperative analgesia [ 11 , 12 ]. Some researchers reported that nalbuphine is primarily acted on kappa receptors to produce analgesia, which can be reversed by naloxone dose-dependently; when acting on μ-receptors, respiratory depression is less than morphine due to the capping effect [ 13 , 14 ].…”