Search

The use of opioid analgesics especially in the postoperative period is commonly used with morphine being the drug of choice Nalbuphine C H NO is a synthetic kappa receptor agonist and partial Mu receptor antagonist opioid drug available and approved in our middle which has been synthesized in an attempt to provide analgesia without the undesirable side effects of pure agonists such as Mu opioids whose main representative is Morphine The possibility of using Nalbuphine as an alternative drug in view of the increasing worldwide addiction dependence rates and therefore alarming rates of opioid overdose deaths may be realized due to its favourable pharmacological profile in terms of adverse effects and its equivalent analgesic potential Thus it was decided to perform a literature review of studies published in the last years in the main databases ldquo PubMed rdquo and ldquo MedLine rdquo to evaluate the basic and clinical scientific evidence about Nalbuphine addiction and its potential role in the current scenario of addiction and dependence to opiates

0,307/ 0,284, respectively, and the pooled RR was 0.78 (95%CI, 0.602–0.997; P = 0.048) for nausea, 0.65 (95%CI, 0.50–0.85; P = 0.001) for vomiting. The incidence of respiratory depression with Nalbuphine and Morphine was 0,075 and 0,197, respectively, and the pooled RR was 0.27 (95%CI, 0.12–0.57; P = 0.001). The most serious side effect of opioid use is respiratory depression. Nalbuphine has a plateau effect on respiratory depression, and it has been shown to reverse the respiratory depression from both intravenous [18] and epidural [19] mu-opioids. Because of the growing number of indications and performance of bariatric surgeries, more obese patients are being admitted in the Intensive Care Unit (ICU) [20]. Among factors predisposing to admission in the ICU are mentioned: male gender, age ≥ 50 years BMI ≥ 60 Kg/m2, diabetes mellitus, OSAS, cardiopathies, venous difficulty and complications in the intra or immediate postoperative [20,21] mainly due to respiratory complications such as pneumonia, thromboembolic disease, respiratory failure requiring mechanical ventilation and to a lesser extent, respiratory arrest [21-23]. Postoperative complications and stay in the ICU increase hospital costs [22]. The opposite is also true, fewer complications reduce hospital stay and therefore lessen hospital costs [24]. At postoperative, obeses present difficulties in early mobilization. Immobility increases the risk of adverse thromboembolitic events, especially in surgeries of the upper abdomen [24]. On the other hand, early walking reduces the risk of pulmonary thromboembolism and other respiratory problems at postoperative affording and improving lung expansion, minimizing and reverting atelectasias formed by the prolonged decubitus in the bed [20].