[Comparative clinical studies of the hemodynamic parameters by anesthesia combination with Nalbuphin (Nubain) and...

The narcotic agonist-antagonist nalbuphine is reported to act as a strong analgesic with only minor respiratory depressant side-effects. Even in the postoperative period, the pain-relieving properties of analgesic drugs are reported to continue if the respiratory side-effects are being antagonized by administering nalbuphine. It was the aim of this study to investigate the analgesic properties of nalbuphine as compared to those of fentanyl, in suppressing the hemodynamic responses due to endotracheal intubation and skin incision. Furthermore, we are interested in studying postoperative analgesia and respiratory depression after using the two drugs during anesthesia.

Forty-one patients undergoing general surgical procedures were randomly assigned to two groups in a double-blind study. The patients were between 18 and 70 years old and belonged to ASA classes I-III. Patients with chronic obstructive pulmonary disease, cerebral vascular disorders, hepatic or renal failure, or those treated with monoamine oxidase inhibitors and tricyclic antidepressants were excluded from the study, as were patients with a drug dependency. All patients were premedicated with 25-50 mg each promethazine and pethidine. Anesthesia was induced with either 60-70 mg nalbuphine or 0.3-0.35 mg fentanyl, 2 mg alcuronium, 0.01 mg/kg flunitrazepam, and 1-2 mg/kg thiopental. All patients were intubated following 1-2 mg/kg succinylcholine. Five minutes following intubation they received another 30-40 mg nalbuphine or 0.15-0.2 mg fentanyl intravenously. Anesthesia was maintained with N2O:O2 2:1, alcuronium, and either nalbuphine or fentanyl and enflurane up to 1 vol.% or halothane up to 0.5 vol.%. Blood pressure, pulse rate, and arterial blood gases were measured at certain intervals.(ABSTRACT TRUNCATED AT 250 WORDS)