A study has shown the kappa-opioid receptor agonist nalbuphine appears to provide subpar analgesic effects compared with the mu receptor agonist sufentanil when added to ropivacaine in the management of labor pain in women.
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There was a total of 180 pregnant women who were about
to give birth and requesting pain reliever during labor were randomized to
receive nalbuphine or sufentanil. Five minutes after the initial dose, the
women were given 10 mL of 0.1% ropivacaine plus either 0.3 mg/mL nalbuphine
solution or 0.3 µg/mL sufentanil.
Initial findings of the duration of analgesia, the
time to the first requirement for additional medication, was significantly
shorter on nalbuphine than on sufentanil.
Moreover, ropivacaine dose per hour in the nalbuphine
group was significantly greater than in the sufentanil group.
There were no serious undesirable events directly
correlated with the analgesics seen either in the mother or in the fetus.
Throughout epidural labor analgesia, the addition of a
small dose of opioids has the potential to enhance the local analgesic effect,
reduce the dose of local anesthetic required, and minimize motor blockade.
Earlier reports cite that kappa-opioid receptor agonists are more effective
than mu receptor agonist for the treatment of visceral pain. Although, the
present study suggests that sufentanil may be preferable to nalbuphine for
women requesting pain reliever during labor.
For complete details of the study, you may click here.
Source: J Clin Pain 2021;doi:10.1097/AJP.0000000000000928