Dose-dependent attenuation of intravenous nalbuphine on epidural morphine-induced pruritus and analgesia after cesarean delivery
| Autor: | Ya-Chun Shen, Yu-Tung Feng, Yu-Ning Sun, Kuang-Yi Tseng, Chen-Yu Long, Kuang-I Cheng, Mao-Kai Chen, Siu-Wah Chau |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2014 |
| Předmět: |
Adult
medicine.medical_specialty Patient-controlled antipruritus Visual analogue scale medicine.medical_treatment Nalbuphine Epidural morphine Young Adult Pregnancy medicine Elective Cesarean Delivery Humans Cesarean delivery Saline Demography Pain Measurement Medicine(all) Pain Postoperative lcsh:R5-920 Dose-Response Relationship Drug Morphine business.industry Cumulative dose Cesarean Section Pruritus Analgesia Patient-Controlled General Medicine Surgery Analgesia Epidural Anesthesia Injections Intravenous Female business lcsh:Medicine (General) medicine.drug |
| Zdroj: | Kaohsiung Journal of Medical Sciences, Vol 30, Iss 5, Pp 248-253 (2014) |
| Popis: | 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. |
| Databáze: | OpenAIRE |
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