Naloxone versus nalbuphine for treatment of intrathecal morphine-induced side effects

ABSTRACT

This study included 200 adult male and female patients undergoing lower abdominal and anorectal surgeries under spinal anesthesia. All patients received [3 ml bupivacaine 0.5% + 1 mg morphine] intrathecally. Patients were observed for 24 hours postoperatively. One hundred patients requested treatment for moderate to severe symptoms [pruritus, nausea and/or vomiting]. According to the drug used to treat intrathecal morphine-induced side effects, patients were divided randomly into two equal [each of 50] groups Group I, received nalbuphine in a dose of 2 mg for a maximum of 6 doses [12 mg] and group II, received naloxone in a dose of 0.08 mg for a maximum of 6 doses [0.48 mg]. The remaining 100 patients developed no or mild symptoms requiring no treatment. Those patients constituted group III. Intrathecal morphine in a dose of 1 mg produced moderate to severe side effects [pruritus, nausea and/or vomiting and urinary retention] in a 50% of patients. No incidence of respiratory depression was observed at this dose. Both naloxone and nalbuphine were effective and safe in treating the side effects of intrathecal morphine. However, there was an evidence that nalbuphine may be superior than naloxone as regards the possibility to reverse intrathecal morphine-induced analgesia