Abstract | PURPOSE: This investigation evaluated the efficacy of nalbuphine in treating postoperative opioid-induced pruritus (Pr) in pediatric patients. METHODS: After Ethics Board approval, the dual site, tertiary care teaching centre study recruited 212 subjects, age > or = seven years, who received opioid analgesia postoperatively. A modified, self-report colour analogue scale (CAS) scored pruritus intensity (PrI). Subjects who reported PrI score > or = 5/10 were randomized to treatment with nalbuphine 50 microg x kg(-1) iv (max 5 mg) or saline placebo. A pruritus intensity difference ( PrID) > or = 50% was considered a positive outcome. RESULTS: Of 260 subjects approached, 212 consented and 184 received opioids. Median age was 13 yr (range 7-19) and median weight was 51 kg (range 19.6-134.8 kg). Pruritus intensity > or = 5/10 occurred in 37 (20.1%) subjects. Intravenous morphine [ patient-controlled analgesia (PCA)/continuous infusion] was associated with Pr in 68% of subjects over a wide dose range (9.4-63.2 mug.kg(-1).hr(-1)). Pruritus occurred in 36% of patients in the PCA group compared to continuous opioid infusion (27%) and epidural administration (27%). Pruritus intensity difference > or = 50% was achieved in 55.6% of nalbuphine and 57.9% of saline-treated subjects. CONCLUSION: This preliminary report suggests that nalbuphine 50 microg x kg(-1) iv is not effective in treating postoperative opioid-induced pruritus in pediatric patients. The modified CAS score and PrID warrant further investigation.
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Authors | Nao Nakatsuka, Sean C Minogue, Joanne Lim, Carolyne J Montgomery, Colleen A Court, Stephan Malherbe, Yvonne Csanyi-Fritz, Ramona A Kearney, Leeann Phillips, Kathy Reid, Justin Kingsley, J Mark Ansermino |
Journal | Canadian journal of anaesthesia = Journal canadien d'anesthesie
(Can J Anaesth)
Vol. 53
Issue 11
Pg. 1103-10
(Nov 2006)
ISSN: 0832-610X [Print] United States |
PMID | 17079637
(Publication Type: Journal Article, Multicenter Study, Randomized Controlled Trial)
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Chemical References |
- Analgesics, Opioid
- Narcotic Antagonists
- Nalbuphine
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Topics |
- Adolescent
- Adult
- Analgesics, Opioid
(adverse effects)
- Child
- Data Collection
- Dose-Response Relationship, Drug
- Double-Blind Method
- Female
- Humans
- Injections, Intravenous
- Male
- Nalbuphine
(administration & dosage, therapeutic use)
- Narcotic Antagonists
(administration & dosage, therapeutic use)
- Prospective Studies
- Pruritus
(chemically induced, drug therapy)
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