Comparison of postoperative analgesia and side effects in pediatric laparoscopic surgery with morphine and nalbuphine
Jia Chen,
Cheng-Yu Wang,
John Wei Zhong,
Yu-Hang Cai,
Jianmin Zhang,
Fang Wang,
Mazhong Zhang,
Hongbin Gu,
Hong-Yu Ma,
Zhen Wang,
Junzheng Wu,
Hua-Cheng Liu
Affiliations
Jia Chen
Department of Anaesthesiology and Perioperative Medicine, The Second Affiliated Hospital and Yuying Children’s Hospital of Wenzhou Medical University; Key Laboratory of Paediatric Anaesthesiology, Ministry of Education, Wenzhou Medical University; Key Laboratory of Anaesthesiology of Zhejiang Province, Wenzhou Medical University, Wenzhou, Zhejiang, China
Cheng-Yu Wang
Department of Anaesthesiology and Perioperative Medicine, The Second Affiliated Hospital and Yuying Children’s Hospital of Wenzhou Medical University; Key Laboratory of Paediatric Anaesthesiology, Ministry of Education, Wenzhou Medical University; Key Laboratory of Anaesthesiology of Zhejiang Province, Wenzhou Medical University, Wenzhou, Zhejiang, China
John Wei Zhong
Department of Anaesthesiology and Pain Management, University of Texas Southwestern Medical Centre, Dallas, TX, USA
Yu-Hang Cai
Department of Anaesthesiology and Perioperative Medicine, The Second Affiliated Hospital and Yuying Children’s Hospital of Wenzhou Medical University; Key Laboratory of Paediatric Anaesthesiology, Ministry of Education, Wenzhou Medical University; Key Laboratory of Anaesthesiology of Zhejiang Province, Wenzhou Medical University, Wenzhou, Zhejiang, China
Jianmin Zhang
Department of Anesthesiology, Beijing Children’s Hospital, Capital Medical University, Beijing 100045, China
Fang Wang
Department of Anesthesiology, Beijing Children’s Hospital, Capital Medical University, Beijing 100045, China
Mazhong Zhang
Department of Anesthesiology, Shanghai Children’s Medical Center, Shanghai 200127, China
Hongbin Gu
Department of Anesthesiology, Shanghai Children’s Medical Center, Shanghai 200127, China
Hong-Yu Ma
Department of Anaesthesiology and Perioperative Medicine, The Second Affiliated Hospital and Yuying Children’s Hospital of Wenzhou Medical University; Key Laboratory of Paediatric Anaesthesiology, Ministry of Education, Wenzhou Medical University; Key Laboratory of Anaesthesiology of Zhejiang Province, Wenzhou Medical University, Wenzhou, Zhejiang, China
Zhen Wang
Laboratory Medicine Center, Allergy Center, Department of Transfusion Medicine, Zhejiang Provincial People’s Hospital, Affiliated People’s Hospital, Hangzhou Medical College, Hangzhou, Zhejiang, China
Junzheng Wu
Department of Anesthesia and Pediatrics, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH 45229, USA; Corresponding author
Hua-Cheng Liu
Department of Anaesthesiology and Perioperative Medicine, The Second Affiliated Hospital and Yuying Children’s Hospital of Wenzhou Medical University; Key Laboratory of Paediatric Anaesthesiology, Ministry of Education, Wenzhou Medical University; Key Laboratory of Anaesthesiology of Zhejiang Province, Wenzhou Medical University, Wenzhou, Zhejiang, China; Corresponding author
Summary: There is currently no consensus on the optimal perioperative pain management strategy involving specific opioids. This study aims to compare the postoperative analgesia, the associated side effects between nalbuphine and morphine in children undergoing laparoscopic surgery. One hundred ninety children were randomly assigned to nalbuphine (0.2 mg/kg) or morphine (0.2 mg/kg). Nalbuphine’s analgesic effect was non-inferior to morphine, with similar total rescue analgesic consumption during PACU stay (0.03 ± 0.05mg vs. 0.04 ± 0.06 mg, p > 0.05). Nalbuphine group had a lower incidence of respiratory depression (RR ≤ 10/min) (4.8% vs. 38.6%, p < 0.001), PONV (2.4% vs. 18.1%, p = 0.002), and pruritus (0% vs. 16.9%, p < 0.001) than morphine. Additionally, nalbuphine showed a shorter laryngeal mask airway removal time (13.9 [12.7, 15.1]) compared with morphine (17.0 [15.1, 18.9], p = 0.011). Nalbuphine provides equipotent analgesia with significantly lower incidences of respiratory depression, PONV, and pruritus compared with morphine in pediatric laparoscopic surgery.
