الفهرس 
Review of literatureOnly 14 pages are availabe for public view
Abstract
Summary and conclusion
Ineffective post-operative pain management is associated with various complications and poor outcomes, including longer times to ambulation, longer hospital lengths of stay, higher rates of medical complications, with decreased patient satisfaction.
Acetaminophen IV which is one of the most widely prescribed medications within critical care, as a large observational trial reporting that 64% of ICU patients received Acetaminophen during their stay (Kelly et al, 2016).
Using of opioid analgesics for postoperative pain relief, is a base treatment, but it can also lead to frequent complications including respiratory depression, excessive sleepiness, decreased gastrointestinal motility, nausea, vomiting and spasm of the bile ducts (Cattabriga, 2007).
The present study aimed to compare the efficacy of Acetaminophen IV infusion against Nalbuphine IV injection in relieving post-operative pain, after giving a single dose of 1000 mg of Acetaminophen IV infusion, and 10 mg Nalbuphine IV injection, administered to 100 male patients divided in to two groups each group of 50 patients after they were suspected to lower abdominal surgery.
The primary outcome of this study was the assessment of pain reduction by collecting VAS data in the both groups of patients. The first group administered 1g of Acetaminophen IV infusion while the other group administered 10 mg of Nalbuphine IV injection. VAS data were collected before administering the drugs of study (baseline) and then after 15 min, 1h, 2h, 3h and 4h from giving the both drugs.
The second outcome was to compare the changes occurred in blood glucose level, heart rate, systolic blood pressure and diastolic blood pressure before giving drugs of study and then after 1h, 2h, 3h and 4 h from administering the both drugs.
The third outcome was to record the need for any additional analgesics in both groups which was noted and statistically analyzed.
Finally, was to report adverse effects that happened as a result of the drugs used in this study.
Regarding VAS the study found that the use of Acetaminophen infusion is as effective as Nalbuphine IV in relieving post-operative pain in male patients suspected to lower abdominal surgeries after passing 15 min from administering both drugs and till 1 hr.
Summary and conclusion
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However, Nalbuphine has more prolonged analgesic effect than Acetaminophen infusion, with a respective safety margin after giving a dose of 10 mg Nalbuphine as an IV injection.
Although there were no statistically significant differences between both groups regarding the changes that happened in blood glucose level. Moreover, regarding heart rate, systolic blood pressure and diastolic blood pressure no statistically significant differences between both groups were measured.
Regarding the need for additional analgesics, both groups needed additional analgesia in a statistically insignificant way.
Regarding side effects occurrence, no serious side effects were noticed in both groups of study.
Recommendations:
Further studies may be needed on females, and elderly patients and after other types of surgeries to clarify the efficacy of Acetaminophen against Nalbuphine in post-operative pain relieve.
The study recommends to use multi-dimensional scales instead of single-dimensional scales in pain researches, pain assessments and managements. Multi-dimensional scales (as MPQ and PQAS) can support both the researchers and the therapists with a clearer vision and versatility to the extent of pain feelings, in order to implement the pain management plan, and using principles that maximize efficacy and minimize the adverse effects of pharmacological interventions.
The study recommends to measure interleukin-6 and interleukin-10 in the assessment of pain, which will be useful in detecting the inflammation and the stress effects of pain.
Limitations of the study:
The present study showed some limitations as
a) The study was done only on males.
b) It was performed on one type of surgeries, (which was lower abdominal surgery).
c) Number of subjects was relatively low.
d) The study used only single-dimensional scales for assessing pain, (which was VAS).
e) The study was conducted at one site, (which was El-Shourouk police hospital).