1Departments of Pain Management and Palliative Medicine
2Department of Anesthesiology
3Departments of Obstetrics and Gynecology
4Department of Colorectal Surgery St. Martin de Porres Hospital, Chia-yi City, Taiwan, R.O.C.
The aim of the study is to observe the clinical efficacy and safety of an agonist-antagonist opioid analgesic –nalbuphine sebacate, a new long-acting injectable pain killer, combined with parecoxib for post-surgical pain management.
We collected 10 patients who underwent surgical procedures and received nalbuphine sebacate 150 mg via deep intramuscular and Parecoxib 40 mg via intravenous injection postoperatively. We evaluated its analgesic efficacy and safety using a verbal ranking pain scale ( 0-10 ) at rest and during movement, a sedation scale by Ramsay Sedation Score ( 1-6 ), scales for mood state induced by pain ( 0-3 ), quality of sleep ( 0-3 ), and satisfaction ( 0-4 ) and adverse effects.
Data were collected in the post-anesthesia care unit, and in the general ward and at home 24, 48, 72 hours and 7 days after surgery.
There was no interference with mood and sleep after injection of nalbuphine sebacate , and also no significant differences in the sedation scale during the recovery period and following days after surgery. All data showed statistically significant improvement in the pain score after treatment compared with the post-anesthesia recovery period in the recovery room ( p<0.05 ). Adverse effects included dizziness (50%), nausea (20%), vomiting (10%), and somnolence (10%), most of which improved after 2 to 3 days.
Nalbuphine sebacate combined with parecoxib was found to be effective in the treatment of post-surgical pain. Nalbuphine sebacate is an obviously potent analgesic, with a long duration of action, but with a slow onset of action and
limited adverse effects. However, we need more cases to prove these results in the future.
Nalbuphine Sebacate, Parecoxib, Post-surgical pain, Multi-model analgesia.
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