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A Comparision of Nalbuphine with Morphine for Analgesic Effects and Safety : Meta-Analysis of Randomized Controlled Trials

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 nalbup...

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Autores principales: Zeng, Zheng, Lu, Jianhua, Shu, Chang, Chen, Yuanli, Guo, Tong, Wu, Qing-ping, Yao, Shang-long, Yin, Ping
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Nature Publishing Group 2015
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4454168/
https://www.ncbi.nlm.nih.gov/pubmed/26039709
http://dx.doi.org/10.1038/srep10927
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author Zeng, Zheng
Lu, Jianhua
Shu, Chang
Chen, Yuanli
Guo, Tong
Wu, Qing-ping
Yao, Shang-long
Yin, Ping
author_facet Zeng, Zheng
Lu, Jianhua
Shu, Chang
Chen, Yuanli
Guo, Tong
Wu, Qing-ping
Yao, Shang-long
Yin, Ping
author_sort Zeng, Zheng
collection PubMed
description 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 saftey 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.
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spelling pubmed-44541682015-06-10 A Comparision of Nalbuphine with Morphine for Analgesic Effects and Safety : Meta-Analysis of Randomized Controlled Trials Zeng, Zheng Lu, Jianhua Shu, Chang Chen, Yuanli Guo, Tong Wu, Qing-ping Yao, Shang-long Yin, Ping Sci Rep Article 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 saftey 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. Nature Publishing Group 2015-06-03 /pmc/articles/PMC4454168/ /pubmed/26039709 http://dx.doi.org/10.1038/srep10927 Text en Copyright © 2015, Macmillan Publishers Limited http://creativecommons.org/licenses/by/4.0/ This work is licensed under a Creative Commons Attribution 4.0 International License. The images or other third party material in this article are included in the article’s Creative Commons license, unless indicated otherwise in the credit line; if the material is not included under the Creative Commons license, users will need to obtain permission from the license holder to reproduce the material. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/
spellingShingle Article
Zeng, Zheng
Lu, Jianhua
Shu, Chang
Chen, Yuanli
Guo, Tong
Wu, Qing-ping
Yao, Shang-long
Yin, Ping
A Comparision of Nalbuphine with Morphine for Analgesic Effects and Safety : Meta-Analysis of Randomized Controlled Trials
title A Comparision of Nalbuphine with Morphine for Analgesic Effects and Safety : Meta-Analysis of Randomized Controlled Trials
title_full A Comparision of Nalbuphine with Morphine for Analgesic Effects and Safety : Meta-Analysis of Randomized Controlled Trials
title_fullStr A Comparision of Nalbuphine with Morphine for Analgesic Effects and Safety : Meta-Analysis of Randomized Controlled Trials
title_full_unstemmed A Comparision of Nalbuphine with Morphine for Analgesic Effects and Safety : Meta-Analysis of Randomized Controlled Trials
title_short A Comparision of Nalbuphine with Morphine for Analgesic Effects and Safety : Meta-Analysis of Randomized Controlled Trials
title_sort comparision of nalbuphine with morphine for analgesic effects and safety : meta-analysis of randomized controlled trials
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4454168/
https://www.ncbi.nlm.nih.gov/pubmed/26039709
http://dx.doi.org/10.1038/srep10927
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