title: A comparision of nalbuphine with morphine for analgesic effects and safety : meta-analysis of randomized controlled trials.
abstract: Although morphine is the standard opioid analgesic for pain control and has been widely used, certain drug-induced adverse effects have been reported as intolerable and need to be addressed. Nalbuphine may have a few advantages over morphine in this respect. We aimed to describe the effect of nalbuphine as well as its safety compared to morphine by analyzing published randomized controlled trials (RCTs) with meta-analysis approach. We analysed 15 trials (820 patients). Overall, there was no evidence to show that the effect of pain relief had any difference between nalbuphine and morphine (pooled relative risks [RRs], 1.01; 95% CI, 0.91 to 1.11; P = 0.90). On the other hand, the incidences of pruritus, nausea, vomiting, respiratory depression were significantly lower in nalbuphine group compared with morphine group, and the pooled RRs were 0.78(95%CI, 0.602-0.997; P = 0.048) for nausea, 0.65(95%CI, 0.50-0.85; P = 0.001) for vomiting, 0.17(95%CI, 0.09-0.34; P < 0.0001) for pruritus, and 0.27(95%CI, 0.12-0.57; P = 0.0007) for respiratory depression. The analgesic efficacy of nalbuphine is comparable to morphine, but nalbuphine provides a better safety profile than morphine in the aspect of certain side-effects, especially related to pruritus and respiratory depression.
authors.affiliation: Medical Student, Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology.
authors.forename: Zheng
authors.initials: Z
authors.lastname: Zeng
authors.affiliation: Medical Student, Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology.
authors.forename: Jianhua
authors.initials: J
authors.lastname: Lu
authors.affiliation: Medical Student, Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology.
authors.forename: Chang
authors.initials: C
authors.lastname: Shu
authors.affiliation: Medical Student, Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology.
authors.forename: Yuanli
authors.initials: Y
authors.lastname: Chen
authors.affiliation: WuXiPRA Clinical Research (Shanghai) Co., Ltd, Shanghai, China.
authors.forename: Tong
authors.initials: T
authors.lastname: Guo
authors.affiliation: Professor, Department of Anesthesiology, University Hospital of Xiehe, Wuhan, China.
authors.forename: Qing-ping
authors.initials: QP
authors.lastname: Wu
authors.affiliation: Professor, Department of Anesthesiology, University Hospital of Xiehe, Wuhan, China.
authors.forename: Shang-long
authors.initials: SL
authors.lastname: Yao
authors.affiliation: Medical Student, Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology.
authors.forename: Ping
authors.initials: P
authors.lastname: Yin
mesh_terms: D000701:Analgesics, Opioid / Q000009:adverse effects / Q000627:therapeutic use*; D006801:Humans; D009020:Morphine / Q000009:adverse effects / Q000627:therapeutic use*; D009266:Nalbuphine / Q000009:adverse effects / Q000627:therapeutic use*; D016017:Odds Ratio; D059408:Pain Management; D016032:Randomized Controlled Trials as Topic; D016896:Treatment Outcome
chemical_list: D000701:Analgesics, Opioid; D009020:Morphine; D009266:Nalbuphine