纳布啡在日间手术预防性多模式镇痛中的优势_West China Medical Journal

Authors：

邓超奕 , 朱倩梅 ,  王晓

四川大学华西医院麻醉科（成都 610041）;

Corresponding author：

王晓, Email: wangxiao2010111@qq.com

Keywords：

纳布啡; 日间手术; 镇痛; 呼吸抑制

DOI：

10.7507/1002-0179.201611041

Video：

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纳布啡作为阿片受体激动-拮抗剂，主要激动 κ 受体，拮抗 μ 受体，减轻了对心血管及呼吸的抑制作用，更好地发挥了镇静、镇痛的作用。同时纳布啡的起效时间快，持续时间长，与其他激动 μ 受体阿片类药物相比，纳布啡的不良反应较少，甚至可拮抗 μ 受体相关的副作用。该文通过回顾纳布啡的机制特点、药理作用，以及近些年来它在国内外日间手术麻醉中的应用，希望为实施日间手术麻醉提供一个新的思路。

Citation： 邓超奕, 朱倩梅, 王晓. 纳布啡在日间手术预防性多模式镇痛中的优势. West China Medical Journal, 2017, 32(11): 1797-1800. doi: 10.7507/1002-0179.201611041 Copy

1.	Miller RD, Cohen NH, Eriksson LI, et al. Miller’s anesthesia. 8th ed. Philadelphia: Elsevier Saunders, 2015: 1050-1051.
2.	Beaver WT, Feise GA. A comparison of the analgesic effect of intramuscular nalbuphine and morphine in patients with postoperative pain. J Pharmacol Exp Ther, 1978, 204(2): 487-496.
3.	Klepper ID, Rosen M, Vickers MD, et al. Respiratory function following nalbuphine and morphine in anaesthetized man. Br J Anaesth, 1986, 58(6): 625-629.
4.	Parker RK, Holtmann B, White PF. Patient-controlled epidural analgesia: interactions between nalbuphine and hydromorphone. Anesth Analg, 1997, 84(4): 757-763.
5.	Yeh YC, Lin TF, Lin FS, et al. Combination of opioid agonist and agonist-antagonist: patient-controlled analgesia requirement and adverse events among different-ratio morphine and nalbuphine admixtures for postoperative pain. Br J Anaesth, 2008, 101(4): 542-548.
6.	Errick JK, Heel RC. Nalbuphine. A preliminary review of its pharmacological properties and therapeutic efficacy. Drugs, 1983, 26(3): 191-211.
7.	Zola EM, Mcleod DC. Comparative effects and analgesic efficacy of the agonist-antagonist opioids. Drug Intell Clin Pharm, 1983, 17(6): 411-417.
8.	Riviere PJ. Peripheral kappa-opioid agonists for visceral pain. Br J Pharmacol, 2004, 141(8): 1331-1334.
9.	Narver HL. Nalbuphine, a non-controlled opioid analgesic, and its potential use in research mice. Lab Anim (NY), 2015, 44(3): 106-110.
10.	Graham JL, McCaughey W, Bell PF. Nalbuphine and pentazocine in an opioid-benzodiazepine sedative technique: a double-blind comparison. Ann R Coll Surg Engl, 1988, 70(4): 200-204.
11.	Sury MR, Cole PV. Nalbuphine combined with midazolam for outpatient sedation. An assessment of safety in volunteers. Anaesthesia, 1988, 43(4): 281-284.
12.	Romagnoli A, Keats AS. Ceiling effect for respiratory depression by nalbuphine. Clin Pharmacol Ther, 1980, 27(4): 478-485.
13.	Gal TJ, DiFazio CA, Moscicki J. Analgesic and respiratory depressant activity of nalbuphine: a comparison with morphine. Anesthesiology, 1982, 57(5): 367-374.
14.	Bressolle F, Khier S, Rochette A, et al. Population pharmacokinetics of nalbuphine after surgery in children. Br J Anaesth, 2011, 106(4): 558-565.
15.	Lee G, Low RI, Amsterdam EA, et al. Hemodynamic effects of morphine and nalbuphine in acute myocardial infarction. Clin Pharmacol Ther, 1981, 29(5): 576-581.
16.	Lake CL, Duckworth EN, DiFazio CA, et al. Cardiovascular effects of nalbuphine in patients with coronary or valvular heart disease. Anesthesiology, 1982, 57(6): 498-503.
17.	Zhang SZ, Wang NF, Xu J, et al. Kappa-opioid receptors mediate cardioprotection by remote preconditioning. Anesthesiology, 2006, 105(3): 550-556.
18.	Zhang Y, Irwin MG, Wong TM, et al. Remifentanil preconditioning confers cardioprotection via cardiac kappa- and delta-opioid receptors. Anesthesiology, 2005, 102(2): 371-378.
19.	Zsigmond EK, Winnie AP, Raza SM, et al. Nalbuphine as an analgesic component in balanced anesthesia for cardiac surgery. Anesth Analg, 1987, 66(11): 1155-1164.
20.	Chawda PM, Pareek MK, Mehta KD. Effect of nalbuphine on haemodynamic response to orotracheal intubation. J Anaesthesiol Clin Pharmacol, 2010, 26(4): 458-460.
21.	Fating DR, Dandekar AK, Tirpude NG. Role of IV nalbuphine in attenuation of haemodynamic response to laryngoscopy and endotracheal intubation. Indian J Clin Anaesth, 2016, 3(2): 165-169.
22.	Gan TJ, Habib AS, Miller TE, et al. Incidence, patient satisfaction, and perceptions of post-surgical pain: results from a US National survey. Curr Med Res Opin, 2014, 30(1): 149-160.
23.	Vanderah TW, Suenaga NM, Ossipov MH, et al. Tonic descending facilitation from the rostral ventromedial medulla mediates opioid-induced abnormal pain and antinociceptive tolerance. J Neurosci, 2001, 21(1): 279-286.
24.	Joshi GP, Ogunnaike BO. Consequences of inadequate postoperative pain relief and chronic persistent postoperative pain. Anesthesiol Clin North America, 2005, 23(1): 21-36.
25.	Kehlet H. Multimodal approach to control postoperative pathophysiology and rehabilitation. Br J Anaesth, 1997, 78(5): 606-617.
26.	Shang AB, Gan TJ. Optimising postoperative pain management in the ambulatory patient. Drugs, 2003, 63(9): 855-867.
27.	Woolf CJ, Chong MS. Preemptive analgesia--treating postoperative pain by preventing the establishment of central sensitization. Anesth Analg, 1993, 77(2): 362-379.
28.	Pogatzki-Zahn EM, Zahn PK. From preemptive to preventive analgesia. Curr Opin Anaesthesiol, 2006, 19(5): 551-555.
29.	Melton MS, Nielsen KC, Tucker M, et al. New medications and techniques in ambulatory anesthesia. Anesthesiol Clin, 2014, 32(2): 463-485.
30.	Kehlet H, Dahl JB. The value of " multimodal” or " balanced analgesia” in postoperative pain treatment. Anesth Analg, 1993, 77(5): 1048-1056.
31.	Jakobsson JG. Pain management in ambulatory surgery-a review. Pharmaceuticals (Basel), 2014, 7(8): 850-865.
32.	Oderda GM, Gan TJ, Johnson BH, et al. Effect of opioid-related adverse events on outcomes in selected surgical patients. J Pain Palliat Care Pharmacother, 2013, 27(1): 62-70.
33.	Zeng Z, Lu J, Shu C, et al. A comparision of nalbuphine with morphine for analgesic effects and safety: meta-analysis of randomized controlled trials. Sci Rep, 2015, 5: 10927.
34.	Gunion MW, Marchionne AM, Anderson C. Use of the mixed agonist-antagonist nalbuphine in opioid based analgesia. Acute Pain, 2004, 6(1): 29-39.
35.	Parsons JD. The use of nalbuphine (nubain) and midazolam in sedation for dentistry. SAAD Dig, 1986, 6(6): 125-131.
36.	Bone ME, Dowson S, Smith G. A comparison of nalbuphine with fentanyl for postoperative pain relief following termination of pregnancy under day care anaesthesia. Anaesthesia, 1988, 43(3): 194-197.
37.	Salman OH. A controlled, double blind, study of adding Nalbuphine to Propofol for laryngeal mask insertion conditions and hemodynamics in adults. Egypt J Anaesth, 2015, 31(4): 277-281.
38.	Chin KW, Tan PK, Chin MK. Sedation for gastroscopy: a comparison between midazolam and midazolam with nalbuphine. Ann Acad Med Singapore, 1994, 23(3): 330-332.
39.	Fournier R, Van Gessel E, Macksay M, et al. Onset and offset of intrathecal morphine versus nalbuphine for postoperative pain relief after total hip replacement. Anesthesiology, 2000, 44(8): 940-945.
40.	Mukherjee A, Pal A, Agrawal J, et al. Intrathecal nalbuphine as an adjuvant to subarachnoid block: what is the most effective dose?. Anesth Essays Res, 2015, 5(2): 171-175.
41.	Liaqat N, Anwar K. Comparison of caudal block and nabuphine for pain management in children. JRMC, 2016, 20(1): 30-32.
42.	Madácsy L, Bertalan V, Szepes A, et al. Effect of nalbuphine on the motility of the sphincter of Oddi in patients with suspected sphincter of Oddi dysfunction. Gastrointest Endosc, 2003, 57(3): 319-323.
43.	Butsch JL, Okoli JA. The effect of nalbuphine on the common bile duct pressure. Am Surg, 1988, 54(5): 253-255.
44.	Vieira ZE, Zsigmond EK, Duarte B, et al. Double-blind comparison of butorphanol and nalbuphine on the common bile duct by ultrasonography in man. Int J Clin Pharmacol, 1993, 31(11): 564-567.

1. Miller RD, Cohen NH, Eriksson LI, et al. Miller’s anesthesia. 8th ed. Philadelphia: Elsevier Saunders, 2015: 1050-1051.
2. Beaver WT, Feise GA. A comparison of the analgesic effect of intramuscular nalbuphine and morphine in patients with postoperative pain. J Pharmacol Exp Ther, 1978, 204(2): 487-496.
3. Klepper ID, Rosen M, Vickers MD, et al. Respiratory function following nalbuphine and morphine in anaesthetized man. Br J Anaesth, 1986, 58(6): 625-629.
4. Parker RK, Holtmann B, White PF. Patient-controlled epidural analgesia: interactions between nalbuphine and hydromorphone. Anesth Analg, 1997, 84(4): 757-763.
5. Yeh YC, Lin TF, Lin FS, et al. Combination of opioid agonist and agonist-antagonist: patient-controlled analgesia requirement and adverse events among different-ratio morphine and nalbuphine admixtures for postoperative pain. Br J Anaesth, 2008, 101(4): 542-548.
6. Errick JK, Heel RC. Nalbuphine. A preliminary review of its pharmacological properties and therapeutic efficacy. Drugs, 1983, 26(3): 191-211.
7. Zola EM, Mcleod DC. Comparative effects and analgesic efficacy of the agonist-antagonist opioids. Drug Intell Clin Pharm, 1983, 17(6): 411-417.
8. Riviere PJ. Peripheral kappa-opioid agonists for visceral pain. Br J Pharmacol, 2004, 141(8): 1331-1334.
9. Narver HL. Nalbuphine, a non-controlled opioid analgesic, and its potential use in research mice. Lab Anim (NY), 2015, 44(3): 106-110.
10. Graham JL, McCaughey W, Bell PF. Nalbuphine and pentazocine in an opioid-benzodiazepine sedative technique: a double-blind comparison. Ann R Coll Surg Engl, 1988, 70(4): 200-204.
11. Sury MR, Cole PV. Nalbuphine combined with midazolam for outpatient sedation. An assessment of safety in volunteers. Anaesthesia, 1988, 43(4): 281-284.
12. Romagnoli A, Keats AS. Ceiling effect for respiratory depression by nalbuphine. Clin Pharmacol Ther, 1980, 27(4): 478-485.
13. Gal TJ, DiFazio CA, Moscicki J. Analgesic and respiratory depressant activity of nalbuphine: a comparison with morphine. Anesthesiology, 1982, 57(5): 367-374.
14. Bressolle F, Khier S, Rochette A, et al. Population pharmacokinetics of nalbuphine after surgery in children. Br J Anaesth, 2011, 106(4): 558-565.
15. Lee G, Low RI, Amsterdam EA, et al. Hemodynamic effects of morphine and nalbuphine in acute myocardial infarction. Clin Pharmacol Ther, 1981, 29(5): 576-581.
16. Lake CL, Duckworth EN, DiFazio CA, et al. Cardiovascular effects of nalbuphine in patients with coronary or valvular heart disease. Anesthesiology, 1982, 57(6): 498-503.
17. Zhang SZ, Wang NF, Xu J, et al. Kappa-opioid receptors mediate cardioprotection by remote preconditioning. Anesthesiology, 2006, 105(3): 550-556.
18. Zhang Y, Irwin MG, Wong TM, et al. Remifentanil preconditioning confers cardioprotection via cardiac kappa- and delta-opioid receptors. Anesthesiology, 2005, 102(2): 371-378.
19. Zsigmond EK, Winnie AP, Raza SM, et al. Nalbuphine as an analgesic component in balanced anesthesia for cardiac surgery. Anesth Analg, 1987, 66(11): 1155-1164.
20. Chawda PM, Pareek MK, Mehta KD. Effect of nalbuphine on haemodynamic response to orotracheal intubation. J Anaesthesiol Clin Pharmacol, 2010, 26(4): 458-460.
21. Fating DR, Dandekar AK, Tirpude NG. Role of IV nalbuphine in attenuation of haemodynamic response to laryngoscopy and endotracheal intubation. Indian J Clin Anaesth, 2016, 3(2): 165-169.
22. Gan TJ, Habib AS, Miller TE, et al. Incidence, patient satisfaction, and perceptions of post-surgical pain: results from a US National survey. Curr Med Res Opin, 2014, 30(1): 149-160.
23. Vanderah TW, Suenaga NM, Ossipov MH, et al. Tonic descending facilitation from the rostral ventromedial medulla mediates opioid-induced abnormal pain and antinociceptive tolerance. J Neurosci, 2001, 21(1): 279-286.
24. Joshi GP, Ogunnaike BO. Consequences of inadequate postoperative pain relief and chronic persistent postoperative pain. Anesthesiol Clin North America, 2005, 23(1): 21-36.
25. Kehlet H. Multimodal approach to control postoperative pathophysiology and rehabilitation. Br J Anaesth, 1997, 78(5): 606-617.
26. Shang AB, Gan TJ. Optimising postoperative pain management in the ambulatory patient. Drugs, 2003, 63(9): 855-867.
27. Woolf CJ, Chong MS. Preemptive analgesia--treating postoperative pain by preventing the establishment of central sensitization. Anesth Analg, 1993, 77(2): 362-379.
28. Pogatzki-Zahn EM, Zahn PK. From preemptive to preventive analgesia. Curr Opin Anaesthesiol, 2006, 19(5): 551-555.
29. Melton MS, Nielsen KC, Tucker M, et al. New medications and techniques in ambulatory anesthesia. Anesthesiol Clin, 2014, 32(2): 463-485.
30. Kehlet H, Dahl JB. The value of " multimodal” or " balanced analgesia” in postoperative pain treatment. Anesth Analg, 1993, 77(5): 1048-1056.
31. Jakobsson JG. Pain management in ambulatory surgery-a review. Pharmaceuticals (Basel), 2014, 7(8): 850-865.
32. Oderda GM, Gan TJ, Johnson BH, et al. Effect of opioid-related adverse events on outcomes in selected surgical patients. J Pain Palliat Care Pharmacother, 2013, 27(1): 62-70.
33. Zeng Z, Lu J, Shu C, et al. A comparision of nalbuphine with morphine for analgesic effects and safety: meta-analysis of randomized controlled trials. Sci Rep, 2015, 5: 10927.
34. Gunion MW, Marchionne AM, Anderson C. Use of the mixed agonist-antagonist nalbuphine in opioid based analgesia. Acute Pain, 2004, 6(1): 29-39.
35. Parsons JD. The use of nalbuphine (nubain) and midazolam in sedation for dentistry. SAAD Dig, 1986, 6(6): 125-131.
36. Bone ME, Dowson S, Smith G. A comparison of nalbuphine with fentanyl for postoperative pain relief following termination of pregnancy under day care anaesthesia. Anaesthesia, 1988, 43(3): 194-197.
37. Salman OH. A controlled, double blind, study of adding Nalbuphine to Propofol for laryngeal mask insertion conditions and hemodynamics in adults. Egypt J Anaesth, 2015, 31(4): 277-281.
38. Chin KW, Tan PK, Chin MK. Sedation for gastroscopy: a comparison between midazolam and midazolam with nalbuphine. Ann Acad Med Singapore, 1994, 23(3): 330-332.
39. Fournier R, Van Gessel E, Macksay M, et al. Onset and offset of intrathecal morphine versus nalbuphine for postoperative pain relief after total hip replacement. Anesthesiology, 2000, 44(8): 940-945.
40. Mukherjee A, Pal A, Agrawal J, et al. Intrathecal nalbuphine as an adjuvant to subarachnoid block: what is the most effective dose?. Anesth Essays Res, 2015, 5(2): 171-175.
41. Liaqat N, Anwar K. Comparison of caudal block and nabuphine for pain management in children. JRMC, 2016, 20(1): 30-32.
42. Madácsy L, Bertalan V, Szepes A, et al. Effect of nalbuphine on the motility of the sphincter of Oddi in patients with suspected sphincter of Oddi dysfunction. Gastrointest Endosc, 2003, 57(3): 319-323.
43. Butsch JL, Okoli JA. The effect of nalbuphine on the common bile duct pressure. Am Surg, 1988, 54(5): 253-255.
44. Vieira ZE, Zsigmond EK, Duarte B, et al. Double-blind comparison of butorphanol and nalbuphine on the common bile duct by ultrasonography in man. Int J Clin Pharmacol, 1993, 31(11): 564-567.

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West China Medical Journal

纳布啡在日间手术预防性多模式镇痛中的优势

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