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Article: Preemptive Intravenous Nalbuphine for the Treatment of Post-Operative Visceral Pain: A Multicenter, Double-Blind, Placebo-Controlled, Randomized Clinical Trial

TitlePreemptive Intravenous Nalbuphine for the Treatment of Post-Operative Visceral Pain: A Multicenter, Double-Blind, Placebo-Controlled, Randomized Clinical Trial
Authors
KeywordsLaparoscopy
Cholecystectomy
Postoperative
Pain
Opioids
Issue Date2021
PublisherAdis International Ltd. The Journal's web site is located at https://www.springer.com/journal/40122
Citation
Pain and Therapy, 2021, v. 10 n. 2, p. 1155-1169 How to Cite?
AbstractIntroduction: Post-operative visceral pain is common in early postoperative period after laparoscopic surgery. As a kappa opioid receptor agonist, the antinociceptive effects of nalbuphine in visceral pain are consistent across a multitude of experimental conditions irrespective of species. We hypothesized that preemptive nalbuphine can decrease the visceral pain for patients with incisional infiltration of ropivacaine after laparoscopic cholecystectomy. Methods: In a multicenter, prospective, double-blind, placebo-controlled, randomized clinical trial, 2094 participants scheduled for laparoscopic cholecystectomy were randomly assigned to receive nalbuphine (Nal group, n = 1029) or placebo (Con group, n = 1027). The Nal group received intravenous nalbuphine 0.2 mg·kg−1 and the Con group received saline in a similar way. The primary endpoint was the effect of nalbuphine on post-operative visceral pain intensity scores within 24 h postoperatively. The total amount of analgesic as well as complications were recorded. Results: A total of 1934 participants were analyzed. Nalbuphine reduced the visceral pain both at rest (β = − 0.1189, 95% CI − 0.23 to − 0.01, P = 0.037) and movement (β = − 0.1076, 95% CI − 0.21 to − 0.01, P = 0.040) compared with placebo. Patients in the Nal group required less frequent supplemental analgesic administration during the first 24 h after surgery. There were fewer patients in the Nal group who experienced nausea and vomiting (PONV) (P = 0.008). Conclusions: Preemptive nalbuphine administered at a dose of 0.2 mg·kg−1 was safe and effective at reducing the postoperative visceral pain and supplemental analgesic use in patients undergoing laparoscopic cholecystectomy. Trial Registration: Chinese Clinical Trial Registry; ChiCTR1800014379.
Persistent Identifierhttp://hdl.handle.net/10722/306334
ISSN
2020 Impact Factor: 5.725
PubMed Central ID
ISI Accession Number ID

 

DC FieldValueLanguage
dc.contributor.authorLiu, X-
dc.contributor.authorHu, J-
dc.contributor.authorHu, X-
dc.contributor.authorLi, R-
dc.contributor.authorLi, Y-
dc.contributor.authorWong, G-
dc.contributor.authorZhang, Y-
dc.contributor.authorTang, L-
dc.contributor.authorChai, X-
dc.contributor.authorXie, Y-
dc.contributor.authorLu, M-
dc.contributor.authorXia, X-
dc.contributor.authorWang, J-
dc.contributor.authorGao, X-
dc.contributor.authorZhang, Q-
dc.contributor.authorWang, X-
dc.contributor.authorZhang, Q-
dc.contributor.authorWang, S-
dc.contributor.authorJu, X-
dc.contributor.authorChen, J-
dc.contributor.authorGao, F-
dc.contributor.authorMen, X-
dc.contributor.authorLiu, C-
dc.contributor.authorYang, X-
dc.contributor.authorXu, H-
dc.contributor.authorWang, X-
dc.contributor.authorZhan, R-
dc.contributor.authorWang, L-
dc.contributor.authorWang, H-
dc.date.accessioned2021-10-20T10:22:09Z-
dc.date.available2021-10-20T10:22:09Z-
dc.date.issued2021-
dc.identifier.citationPain and Therapy, 2021, v. 10 n. 2, p. 1155-1169-
dc.identifier.issn2193-8237-
dc.identifier.urihttp://hdl.handle.net/10722/306334-
dc.description.abstractIntroduction: Post-operative visceral pain is common in early postoperative period after laparoscopic surgery. As a kappa opioid receptor agonist, the antinociceptive effects of nalbuphine in visceral pain are consistent across a multitude of experimental conditions irrespective of species. We hypothesized that preemptive nalbuphine can decrease the visceral pain for patients with incisional infiltration of ropivacaine after laparoscopic cholecystectomy. Methods: In a multicenter, prospective, double-blind, placebo-controlled, randomized clinical trial, 2094 participants scheduled for laparoscopic cholecystectomy were randomly assigned to receive nalbuphine (Nal group, n = 1029) or placebo (Con group, n = 1027). The Nal group received intravenous nalbuphine 0.2 mg·kg−1 and the Con group received saline in a similar way. The primary endpoint was the effect of nalbuphine on post-operative visceral pain intensity scores within 24 h postoperatively. The total amount of analgesic as well as complications were recorded. Results: A total of 1934 participants were analyzed. Nalbuphine reduced the visceral pain both at rest (β = − 0.1189, 95% CI − 0.23 to − 0.01, P = 0.037) and movement (β = − 0.1076, 95% CI − 0.21 to − 0.01, P = 0.040) compared with placebo. Patients in the Nal group required less frequent supplemental analgesic administration during the first 24 h after surgery. There were fewer patients in the Nal group who experienced nausea and vomiting (PONV) (P = 0.008). Conclusions: Preemptive nalbuphine administered at a dose of 0.2 mg·kg−1 was safe and effective at reducing the postoperative visceral pain and supplemental analgesic use in patients undergoing laparoscopic cholecystectomy. Trial Registration: Chinese Clinical Trial Registry; ChiCTR1800014379.-
dc.languageeng-
dc.publisherAdis International Ltd. The Journal's web site is located at https://www.springer.com/journal/40122-
dc.relation.ispartofPain and Therapy-
dc.rightsThis work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.-
dc.subjectLaparoscopy-
dc.subjectCholecystectomy-
dc.subjectPostoperative-
dc.subjectPain-
dc.subjectOpioids-
dc.titlePreemptive Intravenous Nalbuphine for the Treatment of Post-Operative Visceral Pain: A Multicenter, Double-Blind, Placebo-Controlled, Randomized Clinical Trial-
dc.typeArticle-
dc.identifier.emailWong, G: gordon@hku.hk-
dc.identifier.authorityWong, G=rp00523-
dc.description.naturepublished_or_final_version-
dc.identifier.doi10.1007/s40122-021-00275-8-
dc.identifier.pmid34089152-
dc.identifier.pmcidPMC8586116-
dc.identifier.scopuseid_2-s2.0-85107611229-
dc.identifier.hkuros326697-
dc.identifier.volume10-
dc.identifier.issue2-
dc.identifier.spage1155-
dc.identifier.epage1169-
dc.identifier.isiWOS:000658080000001-
dc.publisher.placeNew Zealand-

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