Document Detail


Prevention of epidural morphine-induced respiratory depression with intravenous nalbuphine infusion in post-thoracotomy patients.
MedLine Citation:
PMID:  2507181     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
The efficacy of nalbuphine, an agonist/antagonist opioid, in preventing respiratory depression from epidural morphine analgesia after thoracotomy, was assessed in a randomized double-blind placebo controlled trial. After a standardized general anaesthetic and 0.15 mg.kg-1 of epidural morphine, patients received a bolus and then a 24 h infusion of nalbuphine (200 micrograms.kg-1 + 50 micrograms.kg-1.hr-1, 100 micrograms.kg-1 + 25 micrograms.kg-1.hr-1, or 50 micrograms.kg-1 + 12.5 micrograms.kg-1.hr-1) or placebo. Blood gases, analgesia, sedation, side effects, and blood nalbuphine concentrations were assessed every two hours for the next 24 h. Fifty-three per cent of placebo-treated patients had a PaCO2 greater than 50 mmHg and 89 per cent of these received naloxone. A 200 micrograms.kg-1 bolus of nalbuphine followed by a 50 micrograms.kg-1.hr-1 infusion achieved a mean steady state blood level of 38.2 ng.ml-1 and prevented CO2 retention greater than 50 mmHg in all but two patients, neither of whom required naloxone. There was no difference in the incidence of side effects among groups, and analgesia appeared to be unaffected by nalbuphine.
Authors:
A D Baxter; B Samson; J Penning; R Doran; L M Dube
Publication Detail:
Type:  Clinical Trial; Journal Article; Randomized Controlled Trial    
Journal Detail:
Title:  Canadian journal of anaesthesia = Journal canadien d'anesthésie     Volume:  36     ISSN:  0832-610X     ISO Abbreviation:  Can J Anaesth     Publication Date:  1989 Sep 
Date Detail:
Created Date:  1989-11-03     Completed Date:  1989-11-03     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  8701709     Medline TA:  Can J Anaesth     Country:  CANADA    
Other Details:
Languages:  eng     Pagination:  503-9     Citation Subset:  IM    
Affiliation:
Department of Anaesthesia, Ottawa General Hospital, Ontario.
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Analgesia, Epidural / adverse effects*
Carbon Dioxide / blood
Double-Blind Method
Female
Humans
Infusions, Intravenous
Male
Middle Aged
Morphinans / therapeutic use*
Morphine / adverse effects*
Nalbuphine / administration & dosage,  blood,  therapeutic use*
Pain, Postoperative / prevention & control
Placebos
Respiratory Insufficiency / chemically induced,  prevention & control*
Thoracotomy* / adverse effects
Chemical
Reg. No./Substance:
0/Morphinans; 0/Placebos; 124-38-9/Carbon Dioxide; 20594-83-6/Nalbuphine; 57-27-2/Morphine

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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