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The analgesic efficacy and side effect profile of nalbuphine 20 mg IV and of nalbuphine 40 mg IV were compared to those of meperidine 75 mg 1M in the immediate postoperative period. Pain intensity, pain relief, additional analgesic requirements and the overall acceptability of the treatment were recorded for 150 patients. No significant differences were found between the groups for any of the efficacy variables. Peak analgesic effects occurred at 15 minutes in both nalbuphine groups and at 30 minutes in the meperidine group. The mean time to additional analgesic medication was approximately 207 minutes in each group. The incidence of nausea and vomiting with meperidine was 22 per cent (95 per cent confidence interval 10 to 34 per cent) and with nalbuphine 20 mg the incidence was two per cent (95%Cl -2 to 6 per cent). This difference was significant (p< 0.01). The difference between nalbuphine 40 mg (10 per cent, 95%CI 1 to 19 per cent) and meperidine, was not considered statistically significant (p = 0.17).
The analgesic efficacy of nalbuphine 20 mg was indistinguishable from that of nalbuphine 40 mg and from that of meperidine 75 mg. The significantly lower incidence of nausea and vomiting with nalbuphine is a major advantage for a recovery room analgesic.
Résumé
On a comparé ľefficacité analgésique et les effets secondaires de 20 mg et de 40 mg de nalbuphine IV à ceux de 75 mg de mépéridine IM dans la période postopératoire immédiate. On a enregistré ľintensité de la douleur, le soulagement de la douleur, tes exigences analgésiques supplémentaires et ľévaluation globale du traitement chez 150patients. On a trouvé aucune différence significative de ľefficacité entre les groupes. Ľanalgésie maximum s’est produite à 15 minutes dans les deux groupes recevant de la nalbuphine et à 30 minutes dans le groupe recevant de la mépéridine. Le temps moyen pour une dose analgésique supplémentaire était ďenviron 207 minutes dans chaque groupe. Ľincidence de nausées et de vomissements après Ľadministration de 20 mg de nalbuphine était de deux pour cent (intervalle de confiance - 2 à 6 pour cent) tandis que ľincidence après ľadministration de 75 mg de mépéridine était de 22 pour cent (IC95% 10 à 34 pour cent). Cette différence était significative (p < 0.01). Ľincidence après 40 mg de nalbuphine était de dix pour cent (IC95% 1 à 19 pour cent; p > 0.05). Ľefficacité analgésique de 20 mg de nalbuphine est indiscernable de celle de 40 mg de nalbuphine et de 75 mg de mépéridine. Ľincidence, significativement plus faible, de nausées et vomissements avec la nalbuphine est un atout important pour un analgésique administré en salle de réveil.
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Hew, E., Foster, K., Gordon, R. et al. A comparison of nalbuphine and meperidine in treatment of postoperative pain. Can J Anaesth 34, 462–465 (1987). https://doi.org/10.1007/BF03014350
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DOI: https://doi.org/10.1007/BF03014350