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Anesth Analg 1987; 66:1155-1164
© 1987 International Anesthesia Research Society
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Nalbuphine as an Analgesic Component in Balanced Anesthesia for Cardiac Surgery

Elemer K. Zsigmond, MD, Alon P. Winnie, MD, Syed M. A. Raza, MD, Xiu Y. Wang, MD, and Eva Barabas, DDS

Received from the Department of Anesthesiology and Anesthesia Research Laboratories, University of Illinois Medical Center at Chicago, Chicago, Illinois.

Abstract

The efficacy and safety of nalbuphine hydrochloride as an IV analgesic used in combination with pretreatment and supplemental doses of diazepam with and without N2O were assessed in 15 patients scheduled to undergo aortocoronary bypass (n = 11) or valve replacement surgery (n = 4). The loading infusion of 3.0 mg/kg nalbuphine given in 20 min 5 min after conclusion of IV injection of 0.4 mg/kg/5 min diazepam caused no significant changes in systolic or diastolic systemic and pulmonary arterial blood pressures or in heart rate, cardiac index, stroke index, systemic and pulmonary vascular resistance, or right and left ventricular stroke work index. After the initial 1-hr loading infusion of 6.66 ± 0.89 mg/kg nalbuphine (mean ± SE), additional nalbuphine infusion maintenance doses of 4.73 ± 0.77, 1.87 ± 0.31, 2.16 ± 0.23, 2.65 ± 0.22, and 2.35 ± 0.44 were used in the subsequent hourly periods to maintain a pain-free state throughout surgery. Hemodynamic changes during the three most stressful periods, tracheal intubation, skin incision, and sternotomy, were not statistically significant. Normal plasma catecholamine and cortisol levels indicate that these patients experienced neither stress nor pain during the maintenance of anesthesia. Nalbuphine caused no significant histamine release. All patients had uncomplicated maintenance of and emergence from anesthesia.

Key Words: ANALGESICS—nalbuphine • ANESTHESIA—cardiovascular






Lippincott, Williams & Wilkins Anesthesia & Analgesia® is published for the International Anesthesia Research Society® by Lippincott Williams & Wilkins with the assistance of Stanford University Libraries' HighWire Press®. Copyright 2006 by the International Anesthesia Research Society. Online ISSN: 1526-7598   Print ISSN: 0003-2999 HighWire Press
Copyright © 1987 by the International Anesthesia Research Society.