nalbuphine and Hypoxia

Topics: Analgesics, Opioid; Animals; Azaperone; Drug Combinations; Hypnotics and Sedatives; Hypoxia; Immobilization; Medetomidine; Nalbuphine; Oxygen; Ursidae

Opioids may depress respiration and contribute to airway obstruction after adenotonsillectomy for obstructive sleep disorder. We compared the respiratory and analgesic effects of nalbuphine, which has a ceiling effect for respiratory depression, and pethidine in 90 children (aged 2-12 years) with a history of obstructive sleep disorder undergoing adenotonsillectomy. Children were scored for their obstructive sleep disorder history and were randomly allocated to receive intravenously at induction of anaesthesia either nalbuphine 0.1 mg.kg-1 (group N) or pethidine 1 mg.kg-1 (group P). End-tidal carbon dioxide was measured in the recovery period using a nasopharyngeal catheter and oxygen saturation whilst breathing air; pain and sedation scores were recorded for 6 h postoperatively. Both groups were similar with respect to the demographic data and respiratory measurements: mean (SD) oxygen saturation on air in the recovery area (96.2% (1.2) vs. 96.5% (1.1) in group N and P, respectively) and mean (SD) end-tidal carbon dioxide (46.4 (5.5) mmHg vs. 47.7 (4) mmHg in group N and P, respectively). High obstructive sleep disorder score, history of apnoea, hyperactivity and loud snoring were found to be the best predictors of early postoperative oxygen desaturation in both groups.

Topics: Adenoidectomy; Analgesics, Opioid; Carbon Dioxide; Child; Child, Preschool; Drug Administration Schedule; Female; Humans; Hypoxia; Male; Meperidine; Nalbuphine; Oxygen; Pain, Postoperative; Postoperative Complications; Respiration; Risk Factors; Sleep Apnea Syndromes; Tonsillectomy

Pulse oximetry was used to assess the degree of hypoxia observed in patients receiving simple midazolam sedation for removal of lower third molars and compared to that seen in patients receiving a combination sedation technique using nalbuphine and midazolam. Results showed that the degree of hypoxia experienced by patients receiving the combination technique was significantly more profound in both incidence and depth than that seen in the group receiving midazolam alone (p less than 0.05).

Topics: Conscious Sedation; Drug Combinations; Humans; Hypoxia; Midazolam; Nalbuphine; Oximetry; Oxygen; Oxygen Consumption