Nalbuphine for analgesia after fracture surgery and its effect on circulating inflammatory factors

Gong,Yong; Zhang,Yang; Tao,Shoujun

doi:10.3892/etm.2017.5452

Nalbuphine for analgesia after fracture surgery and its effect on circulating inflammatory factors

Authors:
- Yong Gong
- Yang Zhang
- Shoujun Tao
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Affiliations: Department of Anesthesiology, the First People's Hospital of Jingzhou, The First Affiliated Hospital of Yangtze University, Jingzhou, Hubei 434020, P.R. China, Department of Anesthesiology, Xiangyang No. 1 People's Hospital, Hubei University of Medicine, Xiangyang, Hubei 441000, P.R. China, Department of Anesthesiology, Hangzhou First People's Hospital, Nanjing Medical University, Hangzhou, Zhejiang 310006, P.R. China
Published online on: November 6, 2017 https://doi.org/10.3892/etm.2017.5452
Pages: 859-863
Copyright: © Gong et al. This is an open access article distributed under the terms of Creative Commons Attribution License.

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Abstract

The present study evaluated the use of nalbuphine for analgesia after fraction reduction surgery. Eighty lower limb fracture patients needing open reduction and internal fixation were selected in the First People's Hospital of Jingzhou from January 2015 to December 2015. Patients were randomly divided into observation and control groups (with 40 cases in each). After surgery, the patients in the observation group were treated with nalbuphine (2 mg/kg) for patient-controlled intravenous analgesia (PCIA), while sufentanil (2.5 µg/kg) was used for patients in the control group. The analgesia treatment lasted for 48 h after surgery. Changes in inflammatory factors and catecholamine hormones during the observation period were determined and compared between the groups. Pain, sedation scores and the number of times the analgesia pump was used were recorded at different time-points. Additionally, the life and sleep qualities and any adverse reactions were also recorded. Our results showed that after the operation, the levels of interleukin-6 (IL-6), tumor necrosis factor-α (TNF-α), interleukin-1 (IL-1), high-sensitivity CRP (hs-CRP) cortisol, adrenaline epinephrine (AD) and norepinephrine (NE) were significantly lower in the observation group than in the control group (p<0.05). Pain and sedation scores of patients in the observation group were better than those in the control group at all time-points after operation (p<0.05). Life and sleep qualities of patients in the observation group were also better than those in the control group (p<0.05). Finally, the rates of nausea, vomiting, dizziness, lethargy, urinary retention, skin itch and constipation were significantly lower in the observation group than in control group (p<0.05). Based on our findings, the application of nalbuphine for analgesia in patients with fracture surgeries can reduce the levels of inflammatory cytokines, improve the analgesic effect, bring beneficial sedative effects and reduce the occurrence of adverse reactions.

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1	Nallam SR, Chiruvella S and Reddy A: Monitored anaesthesia care - Comparison of nalbuphine/dexmedetomidine versus nalbuphine/propofol for middle ear surgeries: A double-blind randomised trial. Indian J Anaesth. 61:61–67. 2017. View Article : Google Scholar : PubMed/NCBI
2	Moustafa AA, Baaror AS and Abdelazim IA: Comparative study between nalbuphine and ondansetron in prevention of intrathecal morphine-induced pruritus in women undergoing cesarean section. Anesth Essays Res. 10:238–244. 2016. View Article : Google Scholar : PubMed/NCBI
3	Tiwari AK, Tomar GS and Agrawal J: Intrathecal bupivacaine in comparison with a combination of nalbuphine and bupivacaine for subarachnoid block: A randomized prospective double-blind clinical study. Am J Ther. 20:592–595. 2013. View Article : Google Scholar : PubMed/NCBI
4	Keller DL, Sanchez-Migallon Guzman D, Klauer JM, KuKanich B, Barker SA, Rodríguez-Ramos Fernández J and Paul-Murphy JR: Pharmacokinetics of nalbuphine hydrochloride after intravenous and intramuscular administration to Hispaniolan Amazon parrots (Amazona ventralis). Am J Vet Res. 72:741–745. 2011. View Article : Google Scholar : PubMed/NCBI
5	Haw AJ, Meyer LC and Fuller A: Nalbuphine and butorphanol reverse opioid-induced respiratory depression but increase arousal in etorphine-immobilized goats (Capra hircus). Vet Anaesth Analg. 43:539–548. 2016. View Article : Google Scholar : PubMed/NCBI
6	Mateshuk-Vatseba L, Pidvalna U and Kost A: Peculiarities of vascular tunic microstructure of the white rat eyeball under the effect of opioid. Rom J Morphol Embryol. 56:1057–1062. 2015.PubMed/NCBI
7	Altarifi AA, Rice KC and Negus SS: Effects of µ-opioid receptor agonists in assays of acute pain-stimulated and pain-depressed behavior in male rats: Role of μ-agonist efficacy and noxious stimulus intensity. J Pharmacol Exp Ther. 352:208–217. 2015. View Article : Google Scholar : PubMed/NCBI
8	Chen MK, Chau SW, Shen YC, Sun YN, Tseng KY, Long CY, Feng YT and Cheng KI: Dose-dependent attenuation of intravenous nalbuphine on epidural morphine-induced pruritus and analgesia after cesarean delivery. Kaohsiung J Med Sci. 30:248–253. 2014. View Article : Google Scholar : PubMed/NCBI
9	Wang HJ, Hsiong CH, Ho ST, Lin MJ, Shih TY, Huang PW and Hu OY: Commonly used excipients modulate UDP-glucuro-nosyltransferase 2b7 activity to improve nalbuphine oral bioavailability in humans. Pharm Res. 31:1676–1688. 2014. View Article : Google Scholar : PubMed/NCBI
10	Liao CC, Chang CS, Tseng CH, Sheen MJ, Tsai SC, Chang YL and Wong SY: Efficacy of intramuscular nalbuphine versus diphenhydramine for the prevention of epidural morphine-induced pruritus after cesarean delivery. Chang Gung Med J. 34:172–178. 2011.PubMed/NCBI
11	Prasartritha T, Kunakornsawat S, Tungsiripat R, Jampa J and Throngnumchai R: A prospective randomized trial comparing epidural morphine through intraoperatively placed epidural catheter and intravenous morphine in major lumbar spinal surgery. J Spinal Disord Tech. 23:e43–e46. 2010. View Article : Google Scholar : PubMed/NCBI
12	Anderson C, Boehme S, Ouellette J, Stidham C and Mackay M: Physical and chemical compatibility of injectable acetaminophen during simulated y-site administration. Hosp Pharm. 49:42–47. 2014. View Article : Google Scholar : PubMed/NCBI
13	Coetzee JF, Lechtenberg KF, Stock ML and Kukanich B: Pharmacokinetics and effect of intravenous nalbuphine in weaned Holstein calves after surgical castration. J Vet Pharmacol Ther. 37:169–177. 2014. View Article : Google Scholar : PubMed/NCBI
14	Rao ZA, Choudhri A, Naqvi S and Ehsan-Ul-Haq: Walking epidural with low dose bupivacaine plus tramadol on normal labour in primipara. J Coll Physicians Surg Pak. 20:295–298. 2010.PubMed/NCBI
15	Schmitz A, Salgo B, Weiss M, Dillier CM, Frotzler A and Gerber AC: Intrathecal opioid medication for perioperative analgesia in severely handicapped children undergoing spinal operations. Anaesthesist. 59:614–620. 2010.(In German). View Article : Google Scholar : PubMed/NCBI
16	Sanchez-Migallon Guzman D, Braun JM, Steagall PV, Keuler NS, Heath TD, Krugner-Higby LA, Brown CS and Paul-Murphy JR: Antinociceptive effects of long-acting nalbuphine decanoate after intramuscular administration to Hispaniolan Amazon parrots (Amazona ventralis). Am J Vet Res. 74:196–200. 2013. View Article : Google Scholar : PubMed/NCBI
17	Sanchez-Migallon Guzman D, KuKanich B, Heath TD, Krugner-Higby LA, Barker SA, Brown CS and Paul-Murphy JR: Pharmacokinetics of long-acting nalbuphine decanoate after intramuscular administration to Hispaniolan Amazon parrots (Amazona ventralis). Am J Vet Res. 74:191–195. 2013. View Article : Google Scholar : PubMed/NCBI
18	Wang FY, Shen YC, Chen MK, Chau SW, Ku CL, Feng YT and Cheng KI: Equal volumes of undiluted nalbuphine and lidocaine and normal diluted saline prevents nalbuphine-induced injection pain. Acta Anaesthesiol Taiwan. 49:125–129. 2011. View Article : Google Scholar : PubMed/NCBI
19	Kim TH, Kim JM, Lee HH, Chung SH and Hong YP: Effect of nalbuphine hydrochloride on the active phase during first stage of labour: A pilot study. J Obstet Gynaecol. 31:724–727. 2011. View Article : Google Scholar : PubMed/NCBI
20	Larance B, Ambekar A, Azim T, Murthy P, Panda S, Degenhardt L and Mathers B: The availability, diversion and injection of pharmaceutical opioids in South Asia. Drug Alcohol Rev. 30:246–254. 2011. View Article : Google Scholar : PubMed/NCBI