[Nalbuphine in comparison with piritramid and placebo in postoperative pain therapy following intubation anesthesia with halothane. Side effects and effectiveness].
The aim of the study was a comparison of the side-effects and efficacy of nalbuphine, piritramide, and placebo in patients during recovery from halothane anesthesia.


METHODS
Neurosurgical (vertebral surgery) and otolaryngological patients (surgery of face and neck) were operated under halothane anesthesia. Postoperatively 20 patients received 20 mg nalbuphine, 21 patients 15 mg piritramide, and 19 patients 0.9% NaCl for pain therapy in a randomized and double-blind manner. Respiratory function was monitored by blood gas analysis, hemodynamic function by noninvasive measurements. The analgetic and sedative effects were estimated by the patients (visual analog scale) and the investigator (4-point scale). If the treatment was ineffective, the study was interrupted and a known analgesic was prescribed.


RESULTS
The noninvasively measured hemodynamic parameters were unchanged. On the other hand, in the nalbuphine group mean arterial pCO2 increased significantly (max. 55.4 mmHg after 20 min), over the piritramide group (max. 51.2 mmHg before treatment) and the placebo group (max. 55.1 mmHg before treatment). Drowsiness, in 8 patients in each of the treatment groups and 3 patients in the placebo group, was the most frequent side-effect. After nalbuphine the pain threshold was significantly higher than after treatment with piritramide and placebo. The study was interrupted because of inefficacy in no patients from the nalbuphine group, 2 patients from the piritramide group, and 6 patients from the placebo group. There were no differences in the sedative effects.


CONCLUSIONS
Nalbuphine seems to have better analgesic effects then piritramide. Both cause no hemodynamic alterations.(ABSTRACT TRUNCATED AT 250 WORDS)
D000770:Anesthesia, Endotracheal; D001794:Blood Pressure / Q000187:drug effects; D002574:Cervical Vertebrae / Q000601:surgery; D002986:Clinical Trials as Topic; D006221:Halothane; D006801:Humans; D007405:Intervertebral Disc Displacement / Q000601:surgery; D007540:Isonipecotic Acids / Q000008:administration & dosage*; D008159:Lumbar Vertebrae / Q000601:surgery; D009019:Morphinans / Q000008:administration & dosage*; D009266:Nalbuphine / Q000008:administration & dosage* / Q000009:adverse effects; D010038:Otorhinolaryngologic Diseases / Q000601:surgery; D010100:Oxygen / Q000097:blood; D010147:Pain Measurement; D010149:Postoperative Pain / Q000188:drug therapy*; D010892:Pirinitramide / Q000008:administration & dosage* / Q000009:adverse effects; D011897:Random Allocation
D007540:Isonipecotic Acids; D009019:Morphinans; D010892:Pirinitramide; D009266:Nalbuphine; D010100:Oxygen; D006221:Halothane
Nalbuphin im Vergleich mit Piritramid und Plazebo zur postoperativen Schmerztherapie nach Intubationsnarkosen mit Halothan. Nebenwirkungen und Wirksamkeit.