Affiliation:
1. Pharmaceutical company Microkhim Kyiv Ukraine
2. Clinical and Diagnostic Center Pharmbiotest Kyiv Ukraine
3. Sytenko Institute of Spine and Joint Pathology National Academy of Medical Sciences of Ukraine Kharkiv Ukraine
4. Regional Clinical Trauma Hospital Kharkiv Ukraine
Abstract
AimsOur previous 3‐period crossover study in healthy volunteers comparing the pharmacokinetics of nalbuphine nasal spray Apain with parenteral nalbuphine solution demonstrated high bioavailability of the nasal spray and close similarity of pharmacokinetic profiles after intranasal and intramuscular administration, especially within 30 min postdose. The aim of the present study was a noninferiority assessment of nalbuphine nasal spray vs. intramuscular injection for pain relief in postoperative patients.MethodsNinety orthopaedic and traumatology patients were enrolled in this double‐blind, randomized study of the effectiveness and tolerance of a single 10.5 mg dose of nalbuphine nasal spray vs. 10 mg intramuscular injection. The summed pain intensity difference (SPID0–6) calculated using visual analogue scale scores was the primary study endpoint.ResultsOf 90 subjects enrolled, the per‐protocol efficacy population comprised 79 patients; 6 patients in the reference group and 5 patients in the test group were excluded due to remedication. The mean values of study endpoints with 95% confidence interval were as follows in reference and test groups, respectively: SPID0–6 = 228.08 (205.73–250.43) vs. 248.73 9 (225.83–271.63), time to pain relief onset = 0.28 h (0.25–0.31) vs. 0.27 h (0.25–0.29), duration of analgesia = 5.55 h (5.17–5.93) vs. 5.51 h (5.10–5.92), area under the curve = 119.30 (91.17–147.43) vs. 99.81 (74.52–107.10). No statistically significant differences were revealed.ConclusionNalbuphine nasal spray Apain has been proven to be a safe, noninvasive alternative to intramuscular nalbuphine to relieve severe postoperative pain. Designed for self‐administration and dose‐adjusting, the noncontrolled opioid analgesic nalbuphine spray can be used for patient‐controlled analgesia in out‐of‐hospital, field and home settings.
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