The Optimal Dosage of the Nalbuphine Preemptive Analgesia on Postoperative Pain in Patients Undergoing Laparoscopic Cholecystectomy: A Randomised, Controlled, Double-Blind Study.

Abstract

Objective: To investigate the optimal dosage of nalbuphine preemptive analgesia on pain after laparoscopic cholecystectomy.

Study design: A double-blind, randomised study. Place and Duration of the Study: Department of Anaesthesiology, The Affiliated Huai'an Hospital of Xuzhou Medical University, Huai'an Second Hospital, Jiangsu Province, China, from 2020 to 2023.

Methodology: This study enrolled 240 patients requiring elective laparoscopic cholecystectomy. Patients were randomly allocated into four groups receiving placebo (Group NS) or nalbuphine 0.1 mg/kg (Group N1) or 0.2 mg/kg (Group N2) or 0.3 mg/kg (Group N3) intravenously 15 minutes before surgery. The postoperative visual analogue scale (VAS) score, and the rescue analgesic requirement within 72 hours after surgery were evaluated. One-way analysis of variance and a non-parametric Kruskal-Wallis test were used to compare differences between the groups.

Results: The VAS scores at rest and on movement were significantly lower in the N2 and N3 groups compared to the placebo group at 4, 12, 24, and 48 hours after surgery (p <0.05). Moreover, the VAS scores of the N2 group were significantly lower than N1 and N3 groups. The first rescue analgesia time was significantly longer (p <0.05), and the rescue analgesic requirements were considerably reduced in the N2 group than in the placebo group (p <0.05).

Conclusion: Nalbuphine preemptive analgesia provided effective analgesia in patients undergoing laparoscopic cholecystectomy. The results showed that the optimal dose was 0.2 mg/kg for nalbuphine preemptive analgesia in laparoscopic cholecystectomy.

Key words: Nalbuphine, Preemptive analgesia, Laparoscopic cholecystectomy, Postoperative pain, Rescue analgesia, VAS score.