Onset and offset of intrathecal morphine versus nalbuphine for postoperative pain relief after total hip replacement

Abstract

We conclude that after total hip replacement, administration of intrathecal nalbuphine resulted in a significantly faster onset of pain relief and shorter duration of analgesia than intrathecal morphine.

Clinical efficacy of clonidine versus nalbuphine as intrathecal adjuvants to 0.5% hyperbaric bupivacaine for subarachnoid block during gynaecological procedures: a double blind study

“…Nalbuphine is widely studied as an adjuvant to local anesthetics in central neuraxial techniques to improve the quality of perioperative analgesia as it provides reasonably potent analgesia for visceral nociception. 4,5 Clonidine and nalbuphine are freely available and absence of neurotoxicity has already been established. Not much studies have been conducted to compare the clonidine with nalbuphine as intrathecal adjuvants to bupivacaine.…”

Comparison of Analgesic Effects of Intravenous Nalbuphine and Pentazocine in Patients posted for Short-duration Surgeries: A Prospective Randomized Double-blinded Study

“…Many studies have reported that incidence of adverse effects like pruritus and postoperative nausea and vomiting is lower with nalbuphine in comparison with morphine. [4][5][6][7][8][9] Reviews on preclinical pharmacology of this drug suggest that nalbuphine moiety is approximately 10 times more pharmacologically potent than the mixed opioid agonist-antagonist butorphanol on an "antagonist index" scale, which quantitates the drug's ability to act both as an analgesic (via opioid κ-receptor agonism) and as a µ-receptor antagonist. 10 The opioid antagonist activity of nalbuphine is one-fourth as potent as nalorphine and 10 times that of pentazocine.…”

“…Postoperative pain can lead to a multitude of potentially life-threatening adverse physiological and psychological ORIGINAL ARTICLE 1 Senior Resident, 2 Associate Professor, 3,4 Assistant Professor 5 Professor and Head [1][2][3][4][5] Department of Anesthesiology,Critical Care and Pain Medicine, Byramjee Jeejeebhoy Government Medical College and Sassoon General Hospitals, Pune, Maharashtra, India disturbances. A systemic stress response is initiated due to pain and tissue injury associated with surgery, which has neuroendocrine, immunological, and hematological effects.…”

Effects of epidural nalbuphine on intraoperative isoflurane and postoperative analgesic requirements in dogs

“…Other opioids are also used with the same goal, such as fentanyl 3,4 , sufentanil 5,6 , oxymorphone 7 , and especially morphine 1,[8][9][10][11] . Epidural use of morphine has been limited though because of the dose-dependent risk of delayed respiratory depression and/or potential urinary retention requires close monitoring of respiratory patterns, which is not always possible in dogs 11,12 and humans 13 .…”

“…The respiratory depression induced by opioids is primarily mediated by the μ-receptor agonist activity. The μ-antagonist properties of the nalbuphine should produce fewer μ-mediated side effects such as respiratory depression, pruritus, nausea and vomiting 13,14 .…”