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

The effect of nalbuphine on common bile duct (CBD) pressure was studied by measurements through T-tubes on the first and second postoperative days after cholecystectomy and choledochotomy. Nalbuphine in a dose of 0.25 mg X kg-1 was injected intramuscularly in 11 patients, and changes in biliary pressure, heart and respiratory rate, blood pressure, and arterial blood gases were recorded during the subsequent four hours. The patients were free of pain, had stable common bile duct pressures and did not have any statistically significant changes in their vital signs. These results are similar to our previous observations during perioperative intravenous injection of nalbuphine. It is suggested that nalbuphine does not significantly change, or even may relax, the sphincter of Oddi, and can therefore be recommended as a safe analgesic in the postoperative period after extrahepatic biliary surgery.
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PMID:Effect of nalbuphine on intrabiliary pressure in the early postoperative period. 374 17

A double-blind, between-patient comparison of intramuscular pethidine 100 mg and nalbuphine 20 mg for the relief of pain during labour in 80 patients is described. Severity of pain was assessed before and after treatment by subjective pain scores and visual analogue scales. Neither of these methods showed a significant difference between the treatments. Nalbuphine was associated with less maternal nausea and vomiting than pethidine, but this possible advantage was somewhat offset by a tendency of the drug to produce more maternal sedation and dizziness. The mean umbilical vein/maternal vein ratio was significantly higher for nalbuphine (0.78, SEM 0.03) than for pethidine (0.61, SEM 0.02), which suggests easier placental transfer of the former. This finding was reflected in significantly lower 2-4 hour neurobehavioural scores for the infants of mothers given nalbuphine, but there was no significant difference between these scores at 24 hours. On the basis of this study, nalbuphine does not offer a substantial improvement over pethidine for pain relief in labour.
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PMID:A double-blind comparison of intramuscular pethidine and nalbuphine in labour. 381 47

In a double-blind clinical trial of 48 patients, nalbuphine, morphine, and pethidine were compared by on-demand intravenous analgesia during the first 24 hours after cholecystectomy. Overall pain relief (visual analogue score) was recorded by the patients as 50 (SEM 4) for nalbuphine, 44 (SEM 4) for morphine and 53 (SEM 5) for pethidine. These scores were not significantly different. The mean demand for each drug over the 24-hour period was 70 (SEM 12) mg for nalbuphine, 46 (SEM 6) mg for morphine and 614 (SEM 49) mg for pethidine. Pain on movement, either during deep breathing or turning, was found to be less well controlled after nalbuphine (70, SEM 2), and pethidine (67 SEM 7) than after morphine (52, SEM 5; p less than 0.01). The incidence of side effects was similar with each drug. Nalbuphine is a useful postoperative analgesic, as effective as pethidine. Nalbuphine 15 mg is apparently equipotent with morphine 10 mg or pethidine 120 mg by this mode of administration.
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PMID:Self-administered nalbuphine, morphine and pethidine. Comparison, by intravenous route, following cholecystectomy. 389 14

Nalbuphine hydrochloride (Nubain; Du Pont Pharmaceuticals), a synthetic agonist-antagonist analgesic, in a dose of 20 mg was compared with pethidine 100 mg in 60 patients after elective surgery in a random double-blind study. Both drugs were given intramuscularly on the first day after surgery. The pain intensity and visual analogue scales would seem to indicate that nalbuphine has a longer duration of action than pethidine (P less than 0,05). The respiration rates in the pethidine group were significantly more depressed 30 minutes after the injection than in the nalbuphine group (P less than 0,05). Nalbuphine caused less depression of both systolic and diastolic blood pressure at both 30 and 60 minutes (P less than 0,001). The results of the study show that nalbuphine, in the dose used here, may prove to be a useful substitute for pethidine.
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PMID:A comparison of nalbuphine and pethidine for postoperative pain relief after orthopaedic surgery. 389 18

A controlled investigation was conducted to compare the effectiveness of morphine and nalbuphine in the prevention of pain and restlessness after tonsillectomy in children. Sixty children between 4 and 12 years old were randomly allocated to receive intramuscular morphine 0.2 mg/kg, nalbuphine 0.3 mg/kg or no medication approximately 5 minutes before the conclusion of surgery. Pain and restlessness were assessed 1 and 2 hours after injection, and side effects were recorded. The assessments were made double-blind. Both nalbuphine and morphine decreased restlessness and pain 1 hour (p less than 0.01) and 2 hours (p less than 0.05) after surgery. No significant differences were found between the two groups of patients who received opioids. Both nalbuphine and morphine caused more drowsiness than placebo 2 hours after surgery (p less than 0.001). Other side effects were uncommon. Nalbuphine may offer advantages compared with morphine in regard to safety and convenience of use for the treatment of post-tonsillectomy pain in children.
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PMID:Controlled comparison of nalbuphine and morphine for post-tonsillectomy pain. 390 39

We noted the effects of the mixed opiate agonist/antagonist nalbuphine on cardiovascular function and survival in canine hemorrhagic shock. Anesthetized adult mongrel dogs were bled to a mean arterial pressure (MAP) of 45 mmHg, which was maintained with a reservoir for 1 hr before the reservoir was clamped and the animals treated with 0.9% NaCl as a control or nalbuphine at various doses. Shed blood was reinfused 1 hr after the reservoir was clamped, and survival was followed for three days. Nalbuphine at 1-4 mg/kg bolus plus 1-4 mg/kg hr infusion intravenously for 3.5 hr increased MAP, cardiac output, left ventricular contractility, heart rate, and survival. At doses above 8 mg/kg plus 8 mg/kg hr nalbuphine had deleterious effects on these parameters and survival. These effects were dose-dependent and support the hypothesis that endorphins acting on opiate receptors contribute to the cardiovascular pathophysiology of canine hemorrhagic shock. Nalbuphine, furthermore, may be a logical alternative to naloxone, since its analgesic properties obviate the theoretical objection of enhanced pain perception with the use of naloxone in shock.
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PMID:Dose-dependent effects of nalbuphine in canine hemorrhagic shock. 609 33

Nalbuphine is an agonist/antagonist analgesic. After parenteral administration of 'usual' doses it is approximately equipotent in analgesic activity to morphine on a weight basis. In studies in patients with moderate to severe pain, usually following surgery, the characteristics of analgesia with nalbuphine were comparable to those seen with equianalgesic doses of morphine or pentazocine. It also appears to produce satisfactory anaesthesia when used as a component of a 'balanced' anaesthesia technique, although a relatively low 'ceiling' effect for reduction of anaesthetic requirements with nalbuphine may limit its usefulness in this regard. As with other agonist/antagonist analgesics, a 'ceiling' effect to nalbuphine-induced respiratory depression is also seen, beyond which further depression does not readily occur. However, with usual analgesic doses, respiratory depression seen with nalbuphine is comparable to that with morphine. Important haemodynamic changes have not occurred after usual doses of nalbuphine, even in patients with cardiac disease. Like other agonist/antagonist analgesic drugs, the abuse potential of nalbuphine seems relatively low, but only wider clinical use for longer periods can establish this with certainty. Thus, nalbuphine appears to offer a useful alternative to morphine in patients with moderate to severe pain.
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PMID:Nalbuphine. A preliminary review of its pharmacological properties and therapeutic efficacy. 613 54

To compare the respiratory depressant and analgesic effects of nalbuphine and morphine, six healthy male subjects were given the drugs as single 0.15-mg/kg doses, and as four successive doses of 0.15 mg/kg. Respiratory depression was monitored by ventilatory and mouth occlusion pressure responses during CO2 rebreathing, while analgesia to experimental pain was tested with the submaximal effort tourniquet ischemia test. When given as single 0.15 mg/kg doses, both drugs significantly increases the threshold and tolerance for experimental pain. The analgesic effect was similar for both drugs at this dosage, as was depression of the ventilatory and occlusion pressure responses to CO2. Morphine administered in multiple doses progressively increased pain tolerance from 30 +/- 13% above control with the first dose of 0.15 mg/kg to 107 +/- 13% above control after the fourth dose (cumulative total 0.60 mg/kg). Nalbuphine produced a 40 +/- 12% increase in pain tolerance with an initial dose of 0.15 mg/kg, but additional increments of nalbuphine did not result in significantly greater analgesia. The increasing morphine dosage was associated with progressive rightward displacements and ultimately decreases in the slope of the CO2 response curves. Nalbuphine produced an initial rightward displacement of the CO2 response curves similar to morphine, but continued administration of the drug did not result in further displacement or changes in slope. These findings demonstrate that nalbuphine, in contrast to morphine, exhibits a ceiling effect for respiratory depression which is paralleled by its limited analgesic effect on experimental pain.
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PMID:Analgesic and respiratory depressant activity of nalbuphine: a comparison with morphine. 681 1

Nalbuphine (0.1-200 micrograms), unlike morphine (0.1-10 micrograms) administered intrathecally had no effect on the tail flick or hot plate response latencies. In contrast, both intrathecal nalbuphine and morphine inhibited, in a monotonic, dose dependent fashion, the writhing evoked by intraperitoneally administered acetic acid (ED50 = 38 nmol and 1.12 nmol, respectively.) The effects of intrathecal nalbuphine and morphine was antagonized by an equal dose of naloxone administered systemically. Co-intrathecal administration of morphine and nalbuphine revealed that a maximum inhibition of writhing could be obtained with low doses of either drug, while the effects of higher doses of either drug were attenuated as compared to the effects produced by the high dose of either drug alone. These data are consistent with the suggestion that nalbuphine exerts its agonistic effect through a mechanism that is pharmacologically distinct from that of morphine, and the likelihood of two populations of opioid receptors associated with the pain response evoked by thermal and visceral afferents, respectively is considered.
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PMID:The analgetic effects of an intrathecally administered partial opiate agonist, nalbuphine hydrochloride. 689 35

We have studied the analgesic efficacy of a single i.v. dose of tenoxicam 20 mg, given 10 min before induction of anaesthesia in 25 patients undergoing elective Caesarean section. Another group of 25 similar patients served as controls. Nalbuphine consumption in the first 24 h after operation was reduced by 50% when tenoxicam was given. The median time to first request for analgesia was increased from 25 to 110 min in the tenoxicam group. Subjective experiences of pain and sedation were significantly greater in the control group up to 24 h after operation. The haemodynamic variability after intubation was of shorter duration in the tenoxicam group. There was no significant difference in incidence and severity of postoperative nausea and vomiting between the two groups. The surgeon's assessment of uterine relaxation and bleeding, using a visual analogue score, and infant well-being, as judged by Apgar score and cord blood-gas analysis, showed no significant difference between the two groups. There was no evidence of premature closure of the ductus arteriosus or pulmonary hypertension. We conclude that a single i.v. dose of tenoxicam is a useful pretreatment to minimize the haemodynamic variability of light general anaesthesia at induction-delivery and in reducing 24 h postoperative opioid consumption.
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PMID:I.v. tenoxicam for analgesia during caesarean section. 757 99


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