Compared to regular morphine (μ-opioid receptor agonist), the prophylactic or preventive usage of nalbuphine and oxycodone (κ-receptor agonists) during daytime laparoscopic cholecystectomy can lead to significant attenuation of postoperative visceral pain. Additionally, nalbuphine therapy shows reduced adverse reactions, and improved analgesia and patient satisfaction.

Investigators investigated the effect of nalbuphine, oxycodone, and morphine in 124 people for prophylactic analgesia of acute pain following gall bladder surgery. In this randomized, prospective study, volunteers were randomized to get nalbuphine, oxycodone, and morphine. All the groups received 0.15 mg/kg intravenous (iv.) injection prior to incision and 0.05 mg/kg injection at the end of surgery.

The following parameters were examined: (a) Ramsay sedation scores at 1, 2, 4, 8, 12, 16, 20, and 24 hours after operation, (b) Visual Analogue Scale (VAS) pain scores (shoulder pain, incision pain, visceral pain), (c) duration of hospital stay postsurgery, (d) extubation time, (e) occurrence of postsurgery side effects, and (f) patient satisfaction.
In comparison with the morphine group, the VAS scores of visceral pain at rest dropped in the nalbuphine group and oxycodone group at 1-8 h after operation. In comparison with the oxycodone group, the nalbuphine group exhibited a longer decrease in VAS scores of visceral pain at movement. In comparison with the morphine group, the postsurgery time in Ramsay sedation score of the oxycodone group increased longer when compared to the nalbuphine group.

Compared to the nalbuphine group, participants experienced worse sleep quality in the oxycodone group, a longer length of hospital stay in the morphine group, and reduced satisfaction in both groups. Thus, the use of κ-receptor agonists yields satisfactory outcomes in laparoscopic cholecystectomy.