[Comparison of nalbuphine and pentazocine in the treatment of postoperative pain by self-administration].
The side-effects of two opioid agonist-antagonists, nalbuphine and pentazocine, were assessed when used for patient-controlled postoperative analgesia. Forty ASA I or II patients scheduled for upper abdominal surgery were randomly allocated to two equal groups. The anaesthetic technique was the same for all the patients: premedication with atropine and diazepam, induction with thiopentone and suxamethonium and maintenance with fentanyl, pancuronium, nitrous oxide and halothane. Patient-controlled computer assisted analgesia (On-Demand Analgesia Computer) was started in the recovery room at least 2 h after the last administration of fentanyl. The parameters used were: a routine hourly dose (the half of that received during the previous hour), with on demand delivery of nalbuphine (15 micrograms.kg-1) or pentazocine (45 micrograms.kg-1) aliquots respectively, with a refractory period between two demands of 4 min and a total hourly maximum dose of 16 mg and 48 mg respectively. The following parameters were measured before the start of self-administration, and every hour afterwards for 24 h: systolic (Pasys) and diastolic blood pressures, heart rate, pressure-rate product (PRP), respiratory rate, end-tidal CO2 and pain (by way of a three point scale). Analgesia was assessed on a four-point scale every 6 h. The total doses of nalbuphine and pentazocine administered were 94 +/- 43 mg and 251 +/- 150 mg respectively. The only parameters significantly different between the two groups were Pasys and PRP, being higher in the pentazocine group. There were no significant differences in the side-effects (drowsiness, nausea, vomiting, headache, amnesia, logorrhoea and urine retention). All patients in both groups were satisfied with this technique.(ABSTRACT TRUNCATED AT 250 WORDS)
Pandèle
G
G
Département d'Anesthésie et de Réanimation Chirurgicale, Hôpital Bichat, Paris.
Nivoche
Y
Y
Marty
J
J
Desmonts
J M
JM
D000328:Adult; D001794:Blood Pressure / Q000187:drug effects; D002986:Clinical Trials as Topic; D006339:Heart Rate / Q000187:drug effects; D006801:Humans; D008875:Middle Aged; D009019:Morphinans / Q000627:therapeutic use*; D009266:Nalbuphine / Q000008:administration & dosage / Q000627:therapeutic use*; D010149:Postoperative Pain / Q000188:drug therapy*; D010423:Pentazocine / Q000008:administration & dosage / Q000627:therapeutic use*; D012646:Self Administration
D009019:Morphinans; D009266:Nalbuphine; D010423:Pentazocine
Comparaison de la nalbuphine et de la pentazocine dans le traitement de la douleur postopératoire par auto-administration.