RT Journal Article
SR Electronic
T1 Excessive morphine requirements after pre-hospital nalbuphine analgesia.
JF Journal of Accident & Emergency Medicine
JO Arch Emerg Med
FD BMJ Publishing Group Ltd and the British Association for Accident & Emergency Medicine
SP 29
OP 31
DO 10.1136/emj.16.1.29
VO 16
IS 1
A1 K P Houlihan
A1 R G Mitchell
A1 A D Flapan
A1 D J Steedman
YR 1999
UL http://emj.bmj.com/content/16/1/29.abstract
AB Nalbuphine hydrochloride is an opioid agonist-antagonist that has gained acceptance as a pre-hospital analgesic agent. Nalbuphine has equal analgesic properties to morphine, has a low addiction potential, and can be stored and administered without restrictions, unlike morphine. To date no clinical evidence has been published to support the theoretical difficulty that the action of opioids administered after nalbuphine could be altered or negated. The following case reports highlight 10 patients who received nalbuphine pre-hospital and subsequently required higher doses of opioid analgesia than expected. The discussion summarises the properties of nalbuphine and identifies potential reasons why excessive amounts of opioid analgesia were required.