Tags

Type your tag names separated by a space and hit enter

Dose-dependent attenuation of intravenous nalbuphine on epidural morphine-induced pruritus and analgesia after cesarean delivery.
Kaohsiung J Med Sci. 2014 May; 30(5):248-53.KJ

Abstract

Epidural morphine in patient-controlled analgesia regimens controls postoperative pain well but easily induces pruritus and other epidural morphine-related side effects. With 90 pregnant American Society of Anesthesiologists physical status II females scheduled for elective cesarean delivery, the present study was designed to evaluate the efficacy and safety profile of patient-controlled antipruritus (PCP) use of intravenous nalbuphine-based regimens for attenuation of postoperative pruritus and related side effects in combination with epidural morphine patient-controlled analgesia with regard to the quality of postoperative pain management. Patients were randomly assigned to two nalbuphine groups (5 μg/kg/hour, Group N5 or 10 μg/kg/hour, Group N10) and bolus dose of 1.6 μg/kg for PCP or the control (normal saline) group. Comparable visual analog scale scores for rest pain at each measured time interval among the three groups demonstrated that adequate pain relief was offered; however, the cumulative dose of nalbuphine administered to the patients in Group N10 attenuated the analgesic effect of epidural morphine in moving pain at POh24 only. Fewer episodes and milder severity of pruritus were observed in patients in Groups N5 and N10 at all postoperative time intervals. Epidural morphine provided good postoperative pain relief but with incommodious side effects. In addition, intravenous nalbuphine not only attenuated the incidence of pruritus but also decreased total morphine consumption. In conclusion, intravenous administration of low-dose nalbuphine (5 μg/kg/hour) for PCP maintained analgesia produced by epidural morphine and offered low pruritus incidence.

Links

Publisher Full Text (DOI)

Authors+Show Affiliations

Chen MK
Department of Anesthesiology, Kaohsiung Medical University Hospital, Kaohsiung City, Taiwan.
Chau SW
Department of Anesthesiology, Kaohsiung Municipal Hsiao-Kang Hospital, Kaohsiung City, Taiwan.
Shen YC
Department of Anesthesiology, Kaohsiung Medical University Hospital, Kaohsiung City, Taiwan.
Sun YN
Department of Anesthesiology, Kaohsiung Municipal Hsiao-Kang Hospital, Kaohsiung City, Taiwan.
Tseng KY
Department of Anesthesiology, Kaohsiung Medical University Hospital, Kaohsiung City, Taiwan.
Long CY
Department of Obstetrics and Gynecology, Kaohsiung Municipal Hsiao-Kang Hospital, Kaohsiung City, Taiwan; Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung City, Taiwan.
Feng YT
Graduate Institute of Healthcare Administration, Kaohsiung Medical University, Kaohsiung City, Taiwan.
Cheng KI
Department of Anesthesiology, Kaohsiung Medical University Hospital, Kaohsiung City, Taiwan; Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung City, Taiwan. Electronic address: chengkuangi@gmail.com.

MeSH

AdultAnalgesia, EpiduralAnalgesia, Patient-ControlledCesarean SectionDemographyDose-Response Relationship, DrugFemaleHumansInjections, IntravenousMorphineNalbuphinePain MeasurementPain, PostoperativePregnancyPruritusYoung Adult

Pub Type(s)

Journal Article
Randomized Controlled Trial

Language

eng

PubMed ID

24751388

Citation

Chen, Mao-Kai, et al. "Dose-dependent Attenuation of Intravenous Nalbuphine On Epidural Morphine-induced Pruritus and Analgesia After Cesarean Delivery." The Kaohsiung Journal of Medical Sciences, vol. 30, no. 5, 2014, pp. 248-53.
Chen MK, Chau SW, Shen YC, et al. Dose-dependent attenuation of intravenous nalbuphine on epidural morphine-induced pruritus and analgesia after cesarean delivery. Kaohsiung J Med Sci. 2014;30(5):248-53.
Chen, M. K., Chau, S. W., Shen, Y. C., Sun, Y. N., Tseng, K. Y., Long, C. Y., Feng, Y. T., & Cheng, K. I. (2014). Dose-dependent attenuation of intravenous nalbuphine on epidural morphine-induced pruritus and analgesia after cesarean delivery. The Kaohsiung Journal of Medical Sciences, 30(5), 248-53. https://doi.org/10.1016/j.kjms.2014.01.001
Chen MK, et al. Dose-dependent Attenuation of Intravenous Nalbuphine On Epidural Morphine-induced Pruritus and Analgesia After Cesarean Delivery. Kaohsiung J Med Sci. 2014;30(5):248-53. PubMed PMID: 24751388.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Dose-dependent attenuation of intravenous nalbuphine on epidural morphine-induced pruritus and analgesia after cesarean delivery. AU - Chen,Mao-Kai, AU - Chau,Siu-Wah, AU - Shen,Ya-Chun, AU - Sun,Yu-Ning, AU - Tseng,Kuang-Yi, AU - Long,Chen-Yu, AU - Feng,Yu-Tung, AU - Cheng,Kuang-I, Y1 - 2014/02/18/ PY - 2013/03/25/received PY - 2013/10/17/accepted PY - 2014/4/23/entrez PY - 2014/4/23/pubmed PY - 2015/4/7/medline KW - Cesarean delivery KW - Epidural morphine KW - Nalbuphine KW - Patient-controlled antipruritus SP - 248 EP - 53 JF - The Kaohsiung journal of medical sciences JO - Kaohsiung J Med Sci VL - 30 IS - 5 N2 - Epidural morphine in patient-controlled analgesia regimens controls postoperative pain well but easily induces pruritus and other epidural morphine-related side effects. With 90 pregnant American Society of Anesthesiologists physical status II females scheduled for elective cesarean delivery, the present study was designed to evaluate the efficacy and safety profile of patient-controlled antipruritus (PCP) use of intravenous nalbuphine-based regimens for attenuation of postoperative pruritus and related side effects in combination with epidural morphine patient-controlled analgesia with regard to the quality of postoperative pain management. Patients were randomly assigned to two nalbuphine groups (5 μg/kg/hour, Group N5 or 10 μg/kg/hour, Group N10) and bolus dose of 1.6 μg/kg for PCP or the control (normal saline) group. Comparable visual analog scale scores for rest pain at each measured time interval among the three groups demonstrated that adequate pain relief was offered; however, the cumulative dose of nalbuphine administered to the patients in Group N10 attenuated the analgesic effect of epidural morphine in moving pain at POh24 only. Fewer episodes and milder severity of pruritus were observed in patients in Groups N5 and N10 at all postoperative time intervals. Epidural morphine provided good postoperative pain relief but with incommodious side effects. In addition, intravenous nalbuphine not only attenuated the incidence of pruritus but also decreased total morphine consumption. In conclusion, intravenous administration of low-dose nalbuphine (5 μg/kg/hour) for PCP maintained analgesia produced by epidural morphine and offered low pruritus incidence. SN - 2410-8650 UR - https://www.unboundmedicine.com/medline/citation/24751388/Dose_dependent_attenuation_of_intravenous_nalbuphine_on_epidural_morphine_induced_pruritus_and_analgesia_after_cesarean_delivery_ DB - PRIME DP - Unbound Medicine ER -