Abstract
The effect of nalbuphine on common bile duct (CBD) pressure was studied by measurements through T-tubes on the first and second postoperative days after cholecystectomy and choledochotomy. Nalbuphine in a dose of 025 mg·kg-1 was injected intramuscularly in 11 patients, and changes in biliary pressure, heart and respiratory rate, blood pressure, and arterial blood gases were recorded during the subsequent four hours. The patients were free of pain, had stable common bile duct pressures and did not have any statistically significant changes in their vital signs. These results are similar to our previous observations during perioperative intravenous injection of nalbuphine. It is suggested that nalbuphine does not significantly change, or even may relax, the sphincter of Oddi, and can therefore be recommended as a safe analgesic in the postoperative period after extrahepatic biliary surgery.
Résumé
Les effets du nalbuphine sur la pression des voie biliaires (CBD) ont été etudiés par des mesures à travers des tubes en T le premier et second jour post-opératoire après une cholécyctectomie et cholédochotomie. Le nalbuphine à des doses de 0.25 mg·kg-1 a été injecté par voie intramusculaire chez 11 patients et les variations de la pression des voies biliaires, la fréquence cardiaque et respiratoire, la pression artérielle, lagazométrie, ont été enregistrés pour quatre heures après l’administration de nalbuphine. Les patients n’étaient pas souffrants, présentaient des pressions des voies biliaires stables et n’avaient pas de changement statistiquement significatifs de leurs signes vitaux. Ces résultats sont similaires à nos données préalables lors de l’injection intraveineuse de nalbuphine en période péri-opératoire. Il est suggéré que la nalbuphine ne change pas significativement et même peut relâcher le sphincter d’Oddi, et peut ainsi être recommandé comme un analgésique sécuritaire en période post-opératoire après chirurgie biliaire extrahépatique.
Article PDF
Similar content being viewed by others
Avoid common mistakes on your manuscript.
References
Bevan PG. Cholecystectomy in a surgeon. Lancet 1964; 1214.
Economou G, Ward-McQuaid JN. A cross-over comparison of the effect of morphine, pethidine, pentazocine, and phenazocine on biliary pressure. Gut 1971; 12:218.
Franatovic Y, Arguelles JF, Romo-Salas F et al. Intrabiliary pressure changes produced by narcotic drugs and inhalation anesthetics in guinea pigs. Anesth Analg 1979; 58:120.
Tremblay PR, Poncelet P, Dihn DK. Le fentanyl et la pression dans les voies biliares. Can Anaesth Soc J 1973; 20:747.
Lang DW, Pilon RN. Naloxone reversal of morphine-induced biliary colic. Anesth Analg 1980; 59:619.
Jones RM, Fiddian-Green R, Knight PR. Narcotic-induced choledochoduodenal sphincter spasm reversed by glucagon. Anesth Analg 1980; 59:946.
McCammon RL, Stoelting RK, Madura JA. Effects of butorphanol, nalbuphine, and fentanyl on intrabiliary tract dynamics. Anesth Analg 1984; 63:139.
Vatashsky E, Haskel Y. The effect of nalbuphine (Nubaine) compared to morphine and fentanyl on common bile duct pressure. Cur Ther Res 1985; 37:95.
LeQuesne LP, Bolton JP. Choledocholithiasis: incidence, diagnosis and operative procedures.In: Abdominal operations. Ed. Rodney Maingot. 7th ed. vol I, Appleton-Century-Crofts, New York, 1980.
Bussato G. Succinylcholine reverses spasm of the sphincter of Oddi. Anesthesiology 1979; 50:554.
Tammisto T, Tigerstedt I. Comparison of the analgesic effects of intravenous nalbuphine and pentazocine in patients with postoperative pain. Acta Anaesthesiol Scand 1977; 21:390.
Beaver WT, Feise GA. A comparison of the analgesic effect of intramuscular nalbuphine and morphine in patients with postoperative pain. J Pharmacol Exp Ther 1978; 204:487.
Errick JK, Heel RC. Nalbuphine. A preliminary review of its pharmacological properties and therapeutic eficacy. Drugs 1983; 26:211.
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Vatashsky, E., Haskel, Y. Effect of nalbuphine on intrabiliary pressure in the early postoperative period. Can Anaesth Soc J 33, 433–436 (1986). https://doi.org/10.1007/BF03010967
Issue Date:
DOI: https://doi.org/10.1007/BF03010967