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Published in: Pain and Therapy 2/2020

01-12-2020 | Laparotomy | Original Research

Extended-Release Dinalbuphine Sebacate Versus Intravenous Patient-Controlled Analgesia with Fentanyl for Postoperative Moderate-to-Severe Pain: A Randomized Controlled Trial

Authors: Tsung-Kun Chang, Ching-Wen Huang, Wei-Chih Su, Hsiang-Lin Tsai, Cheng-Jen Ma, Yung-Sung Yeh, Yen-Cheng Chen, Ching-Chun Li, Kuang-I. Cheng, Miao-Pei Su, Jaw-Yuan Wang

Published in: Pain and Therapy | Issue 2/2020

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Abstract

Introduction

Post-operative pain control remains unsatisfactory in patients after laparotomy. This study aimed to evaluate the efficacy, safety, and quality of life with a single dose of extended-release dinalbuphine sebacate (ERDS) pre-operatively to intravenous patient-controlled analgesia (PCA) with fentanyl in patients undergoing laparotomy.

Methods

This was a prospective, open-label, randomized controlled study. Of 110 randomized patients, 107 completed all assessments. The area under the curve (AUC) of visual analogue scale (VAS) from baseline to 48 h after surgery, VAS throughout 7 days after surgery, post-operative analgesics use, quality of life, satisfaction, and safety were evaluated.

Results

The AUC of VAS from baseline to 48 h after surgery were 118.6 [97.5% confidence interval (CI) 95.6–141.6] in ERDS group and 176.13 (97.5% CI 150.8–201.4) in PCA group, which showed the non-inferiority because the upper limit of the 97.5% CIs of ERDS group was lower than the lower limit of PCA group (P < 0.001), but also had superiority in favor of ERDS group (P < 0.001). ERDS group reported a significant reduction in VAS pain intensity at 4, 24, 32, 72, 120, and 144 h after surgery, and better quality of life (P < 0.05). The safety profile was comparable between ERDS and PCA groups.

Conclusions

In patients undergoing laparotomy, a single dose of dinalbuphine sebacate was superior to intravenous PCA with fentanyl on lower pain intensity and better quality of life.

Trial Registration

NCT03296488.
Literature
12.
go back to reference Yeh YC, Lin TF, Lin FS, Wang YP, Lin CJ, Sun WZ. Combination of opioid agonist and agonist-antagonist: patient-controlled analgesia requirement and adverse events among different-ratio morphine and nalbuphine admixtures for postoperative pain. Br J Anaesth. 2008;101(4):542–8. https://doi.org/10.1093/bja/aen213.CrossRefPubMed Yeh YC, Lin TF, Lin FS, Wang YP, Lin CJ, Sun WZ. Combination of opioid agonist and agonist-antagonist: patient-controlled analgesia requirement and adverse events among different-ratio morphine and nalbuphine admixtures for postoperative pain. Br J Anaesth. 2008;101(4):542–8. https://​doi.​org/​10.​1093/​bja/​aen213.CrossRefPubMed
Metadata
Title
Extended-Release Dinalbuphine Sebacate Versus Intravenous Patient-Controlled Analgesia with Fentanyl for Postoperative Moderate-to-Severe Pain: A Randomized Controlled Trial
Authors
Tsung-Kun Chang
Ching-Wen Huang
Wei-Chih Su
Hsiang-Lin Tsai
Cheng-Jen Ma
Yung-Sung Yeh
Yen-Cheng Chen
Ching-Chun Li
Kuang-I. Cheng
Miao-Pei Su
Jaw-Yuan Wang
Publication date
01-12-2020
Publisher
Springer Healthcare
Published in
Pain and Therapy / Issue 2/2020
Print ISSN: 2193-8237
Electronic ISSN: 2193-651X
DOI
https://doi.org/10.1007/s40122-020-00197-x

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