Jiayi Tang, Huadong Ni, Ming Yao

Department of Anesthesiology and Pain Research Center, The First Hospital of Jiaxing or The Affiliated Hospital of Jiaxing University, Jiaxing, People’s Republic of China

Correspondence: Huadong Ni; Ming Yao, Department of Anesthesiology and Pain Research Center, The First Hospital of Jiaxing or The Affiliated Hospital of Jiaxing University, No. 1882 South Zhonghuan Road, Nanhu District, Jiaxing, Zhejiang, People’s Republic of China, Tel +86 573 18258359815, Email huadongni@126.com; jxyaoming666@163.com

Purpose: This study aimed to determine the median effective dose (ED50) and effective dose 95% (ED95) of nalbuphine for alleviating moderate-severe catheter-related bladder discomfort (CRBD) after ureteroscopic lithotripsy (URL) in male patients using probit regression analysis.
Patients and Methods: This retrospective study analyzed anesthesia records of all male patients who underwent URL and received nalbuphine under general anesthesia at Jiaxing University Affiliated Hospital between August 2023 and August 2024. Patients were categorized into four groups based on nalbuphine dosage: 0.025, 0.05, 0.075, and 0.10 mg/kg. Data on patient demographics, CRBD scores, agitation scores, the Ramsay sedation scale, and urinary catheter-related pain (UCRP) scores were collected 5 min after laryngeal mask removal. Hemodynamic parameters, including mean blood pressure, heart rate (HR), and oxygen saturation (SPO2), were collected at various time points: post-operation (T0), and at immediately (T1), 5 (T2), 10 (T3), 20 (T4), and 30 min (T5) after laryngeal mask removal. The incidence of adverse events was documented. Probit regression analysis was employed to calculate the ED50 and ED95 of nalbuphine for alleviating moderate-severe CRBD.
Results: Data from 76 anesthesia records were retrieved. CRBD, agitation, and UCRP scores decreased with increasing nalbuphine doses, while the Ramsay sedation scores increased. No significant differences were observed in hemodynamic parameters across dose groups at any time point (P > 0.05). Similarly, the incidence of adverse effects did not differ significantly among the groups (P > 0.05). Probit regression analysis revealed that the ED50 of nalbuphine for alleviating moderate-severe CRBD following URL in male patients was 0.03 mg/kg (95% confidence interval [CI]: 0.013– 0.046), while the ED95 was 0.108 mg/kg (95% CI: 0.085– 0.188).
Conclusion: Nalbuphine is a safe and effective agent for mitigating CRBD, with an ED50 of 0.03 mg/kg and ED95 of 0.108 mg/kg.

Keywords: nalbuphine, ureteroscopic lithotripsy, catheter-related bladder discomfort, median effective dose, men