A Comparison of the Analgesic and Side Effects of Continuous Epidural Morphine and Nalbuphine for Postoperative Pain.
10.4097/kjae.1996.31.6.764
- Author:
So Young JEON
1
;
Sang Ha LEE
;
Byung Yon KWON
Author Information
1. Department of Anesthesiology, Wallace Memorial Baptist Hospital, Seoul, Korea.
- Publication Type:Original Article
- Keywords:
Anesthetic techniques regional;
epidural;
Analgesics morphine;
nalbuphine;
Analgesia postoperative
- MeSH:
Analgesia;
Blood Pressure;
Bupivacaine;
Heart Rate;
Hemodynamics;
Humans;
Incidence;
Infusion Pumps;
Injections, Epidural;
Morphine*;
Nalbuphine*;
Narcotics;
Pain, Postoperative*
- From:Korean Journal of Anesthesiology
1996;31(6):764-770
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
BACKGROUND: A number of recent reports have described the usefulness of the epidural injection of narcotics for the relief of postoperative pain. Morphine, a u-receptor agonist, produce strong analgesic effect with some side effects. Nalbuphine, is a u-antagonist and k-agonist, has an analgesic effect comparable to morphine with little side effects. METHOD: We divided 60 patients into 3 groups utilizing the five-day Baxter Infusor in 0.125% bupivacaine at 0.5 ml/hr: 1) Group M (n=20) received initial 2 mg of bolus + 2 mg/day of maintenance morphine 2) Group N(n=20); initial 4 mg of bolus + maintenance 8 mg/day nalbuphine 3) Group M+N(n=20); initial 2 mg morphine of bolus + maintenance 8 mg/day nalbuphine. Analgesic effect was evaluated by visual analogue scale(0-10) at 6, 12, 18, 24 and 48 hour postoperatively. Changes in blood pressure, heart rate, and incidence of side effects were observed. RESULTS: No significant hemodynamic changes were seen in any of the groups. The patients of group M and M+N get less pain than group N but side-effects of group M were significantly more than group N, M+N. CONCLUSIONS: Nalbuphine hydrochloride could be better agent than morphine in terms of complication and the dose of group M+N (initial morphine 2mg of bolus + maintenance 8 mg/day nalbuphine) may be recommended for postoperative analgesia.
