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Query: UMLS:C0030193 (pain)
 261,466 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Locomotor activity and food and water consumption are potentially indices of post-operative pain in laboratory rodents, but it is important to establish whether these variables are directly affected by opioid analgesics or by halothane anaesthesia in normal rats. The effects of three opioids, buprenorphine, nalbuphine and butorphanol administered alone or following halothane anaesthesia, were studied in groups of normal non-operated adult Wistar rats. All 3 analgesics affected food intake and activity levels, but had little or no effect on water intake. Buprenorphine caused a significant elevation of activity levels and a reduction in food intake at clinical doses (0.01 and 0.05 mg/kg s/c). Nalbuphine (0.5, 1 and 2 mg/kg s/c) caused a reduction in food intake but had a smaller stimulatory effect on locomotion. Butorphanol (0.4 mg/kg s/c) caused a reduction in food intake and elevation in activity. These results suggest that water consumption is likely to be a more reliable variable to use when assessing post-operative pain and the efficacy of analgesics in rats.
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PMID:The effects of buprenorphine, nalbuphine and butorphanol alone or following halothane anaesthesia on food and water consumption and locomotor movement in rats. 150 31

Nalbuphine is a mixed opioid agonist/antagonist, the analgesic properties of which are still open to debate. In a randomized and placebo-controlled protocol, we compared its effects (0.2 mg/kg) on man's perception of multimodal stimuli (i.e., nociceptive, acoustic and visual) to those of aspirin (acetylsalicylic acid, 10 mg/kg) and meperidine (0.5 mg/kg). Amplitudes and latencies of the evoked potentials (EP), tolerance maxima to painful tooth pulp stimuli, and subjective intensity ratings were measured as indicators of drug induced perception differences. After nalbuphine, the EP amplitudes markedly decreased while the stimuli of each modality were rated by the subjects to be of higher intensity. Also, the tolerance maxima of painful tooth pulp stimulation were reduced by nalbuphine, and naloxone did not have additional effects. In contrast, after aspirin and meperidine, the subjective pain ratings corresponded to the reduction of nociceptive EP amplitudes. Tolerance maxima to painful stimulation were also increased by both drugs. While aspirin did not influence acoustic and visual perception, meperidine caused a slight increase in EP amplitudes as well as in the intensity ratings of these stimuli relative to placebo. Thus, at the dose studied, nalbuphine did not act analgetically. The amplitude reduction of nociceptive EP suggested that nalbuphine had analgetic properties. These were, however, not confirmed by subjective pain ratings nor by changes in tolerance maxima.
Pain 1992 Feb
PMID:Nalbuphine does not act analgetically in electrical painful tooth pulp stimulation in man. 158 46

The perfect analgesic regimen is constantly sought, no matter how labor is conducted. The quest for an effective drug that will afford maximum relaxation and pain relief with minimum interruption of any natural homeostatic mechanism is a foremost subject in present obstetric analgesics research. Synthetic alternatives are being offered, promising perfect compatibility with the clinician's demands. Nalbuphine, a semisynthetic narcotic agonist-antagonist analgesic of the penanthren series, is supposed not to be liable to cause respiratory depression and is expected to have fewer side effects. A double-blind, randomised prospective study of 137 patients who received 10 mg nalbuphine or 50 mg pethidine i.v. during the active phase of labor in term was carried out. Maternal cardiovascular variables, pain intensity, progress of labor and fetal heart rate during labor were related to side effect and neonatal outcome (1- and 5-min Apgar scores and umbilical venous pH). Neither regimen showed an advantage over the other. Data analysis points to a possible transient depressive effect induced by nalbuphine on the fetal or neonatal central nervous system.
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PMID:Intravenous pethidine and nalbuphine during labor: a prospective double-blind comparative study. 176 17

A randomized investigation compared the efficacy and safety of nalbuphine administered by two methods, a patient-controlled infuser system and intramuscular (IM) injections, after major gynecologic surgery. Forty-seven patients were randomly assigned to receive nalbuphine by either method. The 22 patients using the infuser were given a 2.0-mg, incremental dose with a 10-minute lock-out interval between doses. A similar group receiving 10-15 mg IM every three hours served as the control. Misprogramming, overdosage, depressed respiration and drug dependence were not encountered. Self-administration provided equally satisfactory sedation and more immediate pain relief without painful injections. Although patients with the infuser had the ability to self-administer more medication, they did not use higher doses of nalbuphine than did the IM group. The additional cost of the infuser system was offset by the satisfaction expressed by the patients and by the improved nursing efficiency. Nalbuphine administered with a patient-controlled infuser provided an effective balance between analgesia and sedation and offered advantages over IM injections.
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PMID:Nalbuphine after major gynecologic surgery. Comparison of patient-controlled analgesia and intramuscular injections. 177 27

The analgesic profile of epidural nalbuphine for postoperative pain relief and the impact of local anaesthetic choice upon this profile was investigated in 58 patients undergoing elective Caesarean delivery under epidural anaesthesia. Patients were randomized to receive either lidocaine 2% with 1:200,000 epinephrine or 2-chloroprocaine 3% for perioperative anaesthesia, followed by either 10, 20, or 30 mg of epidural nalbuphine administered at the first complaint of postoperative discomfort. Postoperative analgesia was quantitated on a visual analogue (VAS) scale, and by the time from the epidural opioid injection until the first request for supplemental pain medication. The duration of analgesia after lidocaine anaesthesia followed by 10, 20 or 30 mg nalbuphine was 77 (53-127) min, 205 (110-269) min, and 185 (116-241), respectively (median, 95% confidence interval, P less than 0.01, 20 and 30 mg vs 10 mg). Following 2-chloroprocaine anaesthesia, VAS remained consistently elevated: the median duration of analgesia was only 30-40 min and did not differ among the three doses of nalbuphine. Side-effects consisted only of somnolence, and were noted only following lidocaine anaesthesia. Somnolence was observed in 0, 20% and 50% of those receiving 10 mg, 20 mg and 30 mg of nalbuphine respectively (NS). No evidence of respiratory depression was noted in any patient. It is concluded that 20 or 30 mg of epidural nalbuphine provides analgesia for only two to four hours following Caesarean delivery with lidocaine anaesthesia, but anaesthesia with 2-chloroprocaine resulted in minimal or no analgesia from this opioid. Nalbuphine appears to be a disappointing agent for epidural use after Caesarean delivery.
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PMID:Epidural nalbuphine for analgesia following caesarean delivery: dose-response and effect of local anaesthetic choice. 191 55

Painful episodes of sickle cell disease remain a source of frustration to patients and health care providers because of the lack of interventions to prevent or control them. Nalbuphine is a potent semisynthetic agonist/antagonist analgesic. We report our experience using nalbuphine as a treatment for painful episodes of sickle cell disease in children. The efficacy of subcutaneous/intramuscular nalbuphine is compared with intramuscular meperidine by a retrospective review of hospitalizations for sickle cell painful episodes. Nalbuphine is as effective as meperidine for the treatment of these episodes. We conclude that nalbuphine is a feasible and effective analgesic and a reasonable treatment option for patients with sickle cell disease experiencing painful episodes.
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PMID:Efficacy of nalbuphine as a parenteral analgesic for the treatment of painful episodes in children with sickle cell disease. 213 23

As most patients undergoing pulmonary surgery by postero-lateral thoracotomy have decreased preoperative pulmonary function, efficient postoperative analgesia is mandatory. Nalbuphine, a new agonist-antagonist opioid analgesic, and nefopam were compared in a double blind trial involving 60 patients. Intravenous injections of 0.3 mg.kg-1 of either drug were started when the patient evaluated his pain as being above 60 mm on a visual scale graduated from 0 to 100 mm. Repeated injections were carried out at the same dose, at the patient's request, after a minimal interval of 3 h for nalbuphine, and 6 h for nefopam. Analgesia was assessed by the visual scale, and by the patient's verbal appraisal. The respiratory and cardiovascular repercussions were evaluated clinically, and by monitoring breathing rate, blood gases, systolic and diastolic blood pressures, heart rate, and consciousness. Nalbuphine provided a convenient analgesia to all patients whereas analgesia with nefopam was insufficient in 15 out of 30 patients. No significant respiratory depression with either drug occurred. Nefopam led to a 30% increase in heart rate for one hour (p less than 0.01). Whereas patients given nalbuphine were more drowsy, although easily aroused, (p less than 0.001), nefopam was responsible for adverse effects (sweating, nausea, tachycardia with pallor, vertigo, malaise) requiring the exclusion of 7 patients from the study. Nalbuphine, although not ideal, would therefore seem to be a better analgesic than nefopam in thoracotomy patients.
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PMID:[Analgesic and respiratory effects of nalbuphine during the immediate postoperative period in thoracotomy]. 218 3

Nalbuphine hydrochloride, an agonist-antagonist opioid, is reported to reverse the respiratory depression of moderate doses of fentanyl (20 micrograms.kg-1) and still provide good analgesia. We report four patients having abdominal aortic aneurysm repair in which we attempted to reverse the respiratory depression of large doses of fentanyl (50-75 micrograms.kg-1) with nalbuphine (0.3 mg.kg-1, 0.1 mg.kg-1 or 0.05 mg.kg-1). Nalbuphine reversed respiratory depression in all four patients and the respiratory rate increased from 10 to 23 breaths per minute, end-tidal CO2 decreased from 7.0 +/- 0.3 per cent to 5.6 +/- 0.7 per cent, and peak inspiratory pressure after 0.1 seconds increased from 4 +/- 1.4 to 13 +/- 2.6 mmHg. However, hypertension, increased heart rate, and significant increase in analogue pain scores accompanied reversal of respiratory depression. Agitation, nausea, vomiting, and cardiac dysrhythmias also were observed frequently. We do not recommend the use of nalbuphine to facilitate early extubation of the trachea after large doses of fentanyl for abdominal aortic surgery.
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PMID:Side effects of nalbuphine while reversing opioid-induced respiratory depression: report of four cases. 165

Nalbuphine is a new partly agonistic antagonistic opioid, that may offer some advantages especially in postoperative pain relief. We compared meperidine (1 mg kg-1) in 100 patients and nalbuphine (0.3 mg kg-1) in 70 patients, administering both agents intravenously after gynaecological operations. Standardised halothane anaesthesia without any opioid was used. After arrival in the recovery room, vigilance (sedation), quality and duration of pain relief were measured by different methods at four different times (0, 15, 30, and 60 minutes). Sedation was significantly more pronounced in the nalbuphine group, but no difference could be found in pain relief and duration between both groups. 6 patients of the n-group showed a short lasting wake-up reaction due to receptor antagonism. 36 patients had to be reinjected at the end of the first hour. We consider nalbuphine to be a safe opioid, however, the marked sedation should be taken into account.
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PMID:[Nalbuphine as compared with pethidine for postoperative pain therapy]. 230 99

We studied the effect of nalbuphine on the ventilatory and occlusion pressure responses to carbon dioxide rebreathing in six healthy male volunteers (mean age 25.5 yr) in a single-blind laboratory study. On four separate days volunteers were assigned randomly to receive either placebo (0.9% sodium chloride) or three i.v. doses of nalbuphine (15, 30 and 60 mg 70 kg-1), followed 90 min later by naloxone 0.4 mg 70 kg-1. Duplicate rebreathing tests were performed and the mean intercept at PE'CO2 7 kPa and the slopes of the linear relationship between inspiratory minute ventilation (Vl) or occlusion pressure (P0.1) with PE'CO2 were measured. Nalbuphine significantly decreased the mean intercept of the Vl (P less than 0.01) and P0.1 (P less than 0.05) responses, but caused no changes in the slopes. No significant difference between the doses was noted, suggesting that an Effect maximum (E'max) for respiratory depression was reached with a dose of approximately 15 mg 70 kg-1. Naloxone was less effective in antagonizing the depression in Vl at the higher dose of nalbuphine. Similar P0.1 values were associated with the same inspiratory flow rate (1 litre s-1) before and after drug treatment, suggesting that nalbuphine acts centrally to depress ventilation. Sedation increased significantly following each dose of nalbuphine (P less than 0.001). No demonstrable difference between the doses was shown, suggesting an Effect maximum (E'max) for sedation was reached at about 15 mg 70 kg-1. Administration of nalbuphine was associated with pain at the injection site, dizziness, dreaming, nausea and vomiting. Cardiovascular stability was maintained in all subjects.
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PMID:Effect of nalbuphine hydrochloride on the ventilatory and occlusion pressure responses to carbon dioxide in volunteers. 250 65


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