Outpatient anesthesia with nalbuphine hydrochloride.

Nalbuphine hydrochloride is a relatively new agonist-antagonist drug structurally related to the potent narcotic, oxymorphone (Numorphan®), and the potent narcotic antagonist, naloxone (Narcan®). (Figure 1.) Nalbuphine has a potency equivalent to morphine sulphate and meperidine (10 mg morphine sulphate and 75 mg meperidine being equivalent to 20 mg nalbuphine), 1 with an abuse potential which is less than that of codeine. The major side effects of nalbuphine appear to be similar to those reported for the narcotic analgesics. Nalbuphine does not appear to affect cardiodynamics. .. 4 When it is used in increasing dosages, respiratory depression reaches a ceiling effect, (approximately 30 mg/70 kg),"' 6 unlike the reaction that occurs with morphine and meperidine that increase respiratory depression with increasing dosages. 7 For these reasons, we will focus on the relative merits of nalbuphine in a balanced anesthesia technique for outpatient surgery.