Influences of Gender on Intravenous Nalbuphine Actions After Major Abdominal Surgery: A Multicenter Study

Inpatient Nalbuphine Substitution During Intravenous IV Opioid Shortage for Acute Pain in a Community Hospital: A Retrospective Review

Nalbuphine's mixed agonist-antagonist activity has historically limited use. This study evaluated the impact of utilizing nalbuphine during admission during a parenteral opioid shortage. A single-center retrospective chart review was performed between January 2018 and June 2018 to compare outcomes between those who received nalbuphine and those who received morphine. The primary outcome was average pain score during admission. Secondary outcomes included: change in parenteral opioid, change in dose, and opioid prescription at discharge. In total, 138 patients, 47 in the nalbuphine group and 91 in the morphine group, were included. Average pain score during admission was 3.97 and 4.13 for nalbuphine and morphine, respectively (p = 0.695). There was no statistically significant change in average pain control on day 1, 2, or last day between groups. In opioid-tolerant patients who inadvertently received nalbuphine, average pain scores were higher compared to the nalbuphine opioid-naïve group, admission (p = 0.003), day 1 (p < 0.001), day 2 (p = 0.016), and last day (p = 0.007). No differences were observed based on sex. No difference in pain scores was observed. Nalbuphine resulted in less pain control in opioid-tolerant patients. Nalbuphine may represent an alternative first-line parenteral opioid in the acute care setting.

Endogenous opiates and behavior: 2021

This paper is the forty-fourth consecutive installment of the annual anthological review of research concerning the endogenous opioid system, summarizing articles published during 2021 that studied the behavioral effects of molecular, pharmacological and genetic manipulation of opioid peptides and receptors as well as effects of opioid/opiate agonizts and antagonists. The review is subdivided into the following specific topics: molecular-biochemical effects and neurochemical localization studies of endogenous opioids and their receptors (1), the roles of these opioid peptides and receptors in pain and analgesia in animals (2) and humans (3), opioid-sensitive and opioid-insensitive effects of nonopioid analgesics (4), opioid peptide and receptor involvement in tolerance and dependence (5), stress and social status (6), learning and memory (7), eating and drinking (8), drug abuse and alcohol (9), sexual activity and hormones, pregnancy, development and endocrinology (10), mental illness and mood (11), seizures and neurologic disorders (12), electrical-related activity and neurophysiology (13), general activity and locomotion (14), gastrointestinal, renal and hepatic functions (15), cardiovascular responses (16), respiration and thermoregulation (17), and immunological responses (18).