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LOW DOSE NALBUPHINE TREATMENT DOES NOT PRODUCE ADEQUATE ANALGESIA IN PREHOSPITAL CARE
Nalbuphine hydrochloride was, until recently, the only intravenous analgesic authorised for use by paramedics. While the manufacturer's datasheet provides guidelines on dosing regimens, in practice these vary in each ambulance Trust. We sought to determine if a low dose regimen, designed to minimise the incidence of respiratory depression, was safe and effective. We found side effects were rare and not clinically significant, but that the regimen resulted in inadequate analgesia in a high proportion of patients. Larger incremental doses delivered over shorter intervals should be adopted. However, these may risk increasing the incidence of side effects, and further research is required to determine the optimal regimen. See page565
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Whiplash injury is common. Yet, many physicians …