Evidence map›Paper›PMID 34110603›Full record

ArticlePain and therapy2021

Influences of Gender on Intravenous Nalbuphine Actions After Major Abdominal Surgery: A Multicenter Study.

Amany E Ayad, Ossama H Salman, Ahmed Mokhtar Fathy Ibrahim, Waleed A M Al-Taher, Adel M Mishriky, Joseph V Pergolizzi, Omar Viswanath, Ivan Urits, Martina Rekatsina, John F Peppin and 2 more

Open access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Pain and therapy, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
0.6field-weighted citation impact, top 32% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed, 5 citations in OpenAlex.

  1. Patient-Controlled Analgesia in ICU: A Scoping Review.Journal of personalized medicine · 2026
    Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors at 12 institutions in 4 countries.

Amany E AyadDepartment of Anesthesia ICU and Pain, Cairo University, Cairo, 11566, Egypt.
Ossama H SalmanDepartment of Anesthesiology, South Valley University, Qena, 83511, Egypt.
Ahmed Mokhtar Fathy IbrahimDepartment of Anesthesiology, Assiut University, Assiut, 71515, Egypt.
Waleed A M Al-TaherDepartment of Anesthesiology, Ain Shams University, Cairo, 11566, Egypt.
Adel M MishrikyDepartment of Community Medicine, Suez Canal University, Ismailia, 41511, Egypt.
Joseph V PergolizziNEMA Research Group, Research and Development, Naples, FL, 34101, USA.
Omar ViswanathDepartment of Anesthesiology, University of Arizona, Phoenix, AZ, 85003, USA.
Ivan UritsDepartment of Anesthesia, Critical Care and Pain Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MS, USA.
Martina RekatsinaWhipps Cross Hospital, Barts Health NHS Trust, London, UK.
John F PeppinCollege of Osteopathic Medicine, Pikeville University, Pikeville, KT, USA.
Antonella PaladiniDepartment of MESVA, University of L'Aquila, 67100, L'Aquila, Italy.
Giustino VarrassiResearch and Development, Paolo Procacci Foundation, via Tacito 7, 00193, Rome, Italy. giuvarr@gmail.com.ORCID http://orcid.org/0000-0002-3822-2923
Ain Shams University · EGAssiut University · EGBarts Health NHS Trust · GBBeth Israel Deaconess Medical Center · USCairo University · EGFondazione Roma · ITNema Research (United States) · USSouth Valley University · EGSuez Canal University · EGUniversity of Arizona · USUniversity of L'Aquila · ITUniversity of Pikeville · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionNalbuphine, a synthetic kappa-opioid receptor (KOR) agonist and a partial µ-opioid receptor (MOR) antagonist, has been used for years as an effective analgesic. It has been shown to have a better safety profile than morphine. Considering the long history of use of this drug, it is interesting that only a limited amount of information exists on how gender differences influence nalbuphine responses. In this randomized double-blind comparative trial after major abdominal surgery, the analgesic effects of two doses of continuous intravenous infusion of nalbuphine were evaluated based on gender.

methodsEnrolled patients were divided into four groups (two females and two males with 32 patients in each group). Two of them (groups A1 and A2), one male and one female, received postoperative continuous intravenous infusions of nalbuphine at 2 mg/h via patient-controlled analgesia (PCA). Each patient had the potential of receiving a rescue bolus of 1 mg of nalbuphine with a lock out time of 15 min. The other two groups (groups B1 and B2) received half the infusion dose, 1 mg/h, and half the nalbuphine rescue dose with the PCA pump, 0.5 mg maximum every 15 min as needed. Patients' vital signs, numerical pain rating scores, rescue nalbuphine, and incidence of side effects were assessed immediately after the operation, and every 3 h during the first 12 h.

resultsNalbuphine 2 mg/h dosing led to significantly lower pain scores amongst females compared to males at 6, 9, and 12 h; while the 1 mg/h infusion pain scores were only lower at the 9-h time period. Females receiving the nalbuphine 2 mg dose at 6 h, and the 1 mg dose at 6, 9, and 12-h measurements needed significantly lower doses of rescue nalbuphine. Females on the 1 mg dose experienced significantly more nausea, vomiting, and sedation at the 6-, 9-, and 12-h measurement times. In the multivariate analysis, female gender was a negative predictor at all measurement times.

conclusionsThe current study supports the hypothesis that although nalbuphine was found to be an effective and well-tolerated analgesic after major abdominal surgery, females were statistically more responsive than males.

trial registrationThe study was registered at the Pan African Clinical trials Registry PACTR201304000486309, and approved for the Ethical aspects.

Indexed as

Agonist-antagonistGender effectNalbuphineOpioids

Identifiers

PMID34110603
PMCPMC8586316
OpenAlexW3167641688

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.