• Tito D Tubog, Jennifer L Harenberg, Kristina Buszta, and Jennifer D Hestand.
• J. Perianesth. Nurs. 2019 Jun 1; 34 (3): 491-501.e8.

PurposeEvaluate the efficacy of prophylactic nalbuphine in preventing neuraxial opioid-induced pruritus.DesignSystematic review and meta-analysis.MethodsFollowing the PRISMA statement, PubMed, CINAHL, Cochrane and EMBASE were searched for eligible studies.FindingsA total of 17 trials consisting of 1,052 patients were evaluated. Compared to placebo, there is low quality of evidence that nalbuphine was effective in reducing the incidence of pruritus in all patient population (RR, 0.66; 95% CI, 0.52 to 0.83; P = .0004) and obstetrics (RR, 0.81; 95% CI, 0.67 to 0.98; P = .03). We also found moderate quality of evidence that nalbuphine lowered pruritus in non-obstetrics, the number of rescue pruritus therapy and severity of pruritus episodes. However, nalbuphine did not cause sedation and affect pain scores.ConclusionsProphylactic nalbuphine decreased the incidence and severity of pruritus without adverse effects on sedation and analgesic effect of opioids.Copyright © 2018 American Society of PeriAnesthesia Nurses. Published by Elsevier Inc. All rights reserved.

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