{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,9]],"date-time":"2026-03-09T04:04:07Z","timestamp":1773029047326,"version":"3.50.1"},"reference-count":25,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2026,3,3]],"date-time":"2026-03-03T00:00:00Z","timestamp":1772496000000},"content-version":"vor","delay-in-days":61,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pain Research and Management"],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:sec>\n                    <jats:title>Context<\/jats:title>\n                    <jats:p>Laparoscopic cholecystectomy (LC) often leads to abdominal wall incision pain, visceral pain, and shoulder and neck pain after surgery. Nalbuphine provides strong sedative and analgesic effects with minimal risk of adverse reactions. Esketamine, with its higher receptor affinity, significantly alleviates both visceral and somatic pain.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>Our objective was to establish the optimal dosage of nalbuphine with esketamine for patient\u2010controlled intravenous analgesia (PCIA) following LC, enhancing postoperative pain management for these patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      This research employs a single\u2010blind, randomized controlled trial methodology. Surgical patients were randomly assigned to three groups based on postoperative PCIA drug combinations: Group N received nalbuphine 2\u2009mg\u00b7kg\n                      <jats:sup>\u22121<\/jats:sup>\n                      with 100\u2009mL of 0.9% sodium chloride solution; Group NE\n                      <jats:sub>1<\/jats:sub>\n                      received esketamine 0.5\u2009mg\u00b7kg\n                      <jats:sup>\u22121<\/jats:sup>\n                      , nalbuphine 2\u2009mg\u00b7kg\n                      <jats:sup>\u22121<\/jats:sup>\n                      , and 100\u2009mL of 0.9% sodium chloride solution; Group NE\n                      <jats:sub>2<\/jats:sub>\n                      received esketamine 1\u2009mg\u00b7kg\n                      <jats:sup>\u22121<\/jats:sup>\n                      , nalbuphine 2\u2009mg\u00b7kg\n                      <jats:sup>\u22121<\/jats:sup>\n                      , and 100\u2009mL of 0.9% sodium chloride solution. The study observed VAS scores at rest and during activity, Ramsay sedation scores, and MoCA scores at 6, 12, 24, and 48\u2009h postsurgery, along with the total and effective PCIA pressing times across the three groups. Adverse reactions and the frequency of rescue analgesia within 48\u2009h postsurgery were monitored.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Compared to the N group, VAS scores and resting pain scores were substantially lower in the NE\n                      <jats:sub>1<\/jats:sub>\n                      and NE\n                      <jats:sub>2<\/jats:sub>\n                      groups at 6\u2009h, 12\u2009h, and 24\u2009h postsurgery (\n                      <jats:italic>p<\/jats:italic>\n                      &lt; 0.05). Compared to Group N, Groups NE\n                      <jats:sub>1<\/jats:sub>\n                      and NE\n                      <jats:sub>2<\/jats:sub>\n                      had reduced postactivity VAS scores at 48\u2009h postsurgery (\n                      <jats:italic>p<\/jats:italic>\n                      &lt; 0.05). Compared to Group NE\n                      <jats:sub>1<\/jats:sub>\n                      , Group NE\n                      <jats:sub>2<\/jats:sub>\n                      had reduced VAS scores at 12\u2009h and 24\u2009h following surgery (\n                      <jats:italic>p<\/jats:italic>\n                      &lt; 0.05). Compared with Group N, the Ramsay sedation scores were higher in Group NE\n                      <jats:sub>1<\/jats:sub>\n                      and Group NE\n                      <jats:sub>2<\/jats:sub>\n                      at 6\u2009h, 12\u2009h, and 24\u2009h following surgery (\n                      <jats:italic>p<\/jats:italic>\n                      &lt; 0.05). Compared with Group NE\n                      <jats:sub>1<\/jats:sub>\n                      , Group NE\n                      <jats:sub>2<\/jats:sub>\n                      had higher Ramsay sedation scores at 6\u2009h and 12\u2009h postoperatively (\n                      <jats:italic>p<\/jats:italic>\n                      &lt; 0.05). The total number of analgesic pump presses and the number of effective presses in the NE\n                      <jats:sub>1<\/jats:sub>\n                      and NE\n                      <jats:sub>2<\/jats:sub>\n                      groups were substantially lower than those in the N group (\n                      <jats:italic>p<\/jats:italic>\n                      &lt; 0.05). Compared with the NE\n                      <jats:sub>1<\/jats:sub>\n                      group, the total number of presses and the number of effective presses in the NE\n                      <jats:sub>2<\/jats:sub>\n                      group were reduced at 24\u2009h and 48\u2009h postoperatively (\n                      <jats:italic>p<\/jats:italic>\n                      &lt; 0.05). Compared with Group N, the cognitive scores on the MoCA scale were markedly increased in Group NE\n                      <jats:sub>1<\/jats:sub>\n                      and Group NE\n                      <jats:sub>2<\/jats:sub>\n                      at 6\u2009h, 12\u2009h, and 24\u2009h postoperatively (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009 &lt; 0.05). The incidence of vomiting was substantially lower in the NE\n                      <jats:sub>1<\/jats:sub>\n                      and NE\n                      <jats:sub>2<\/jats:sub>\n                      groups than in the N group at 48\u2009h postoperatively (\n                      <jats:italic>p<\/jats:italic>\n                      &lt; 0.05). The rate of drowsiness was markedly increased in the NE\n                      <jats:sub>2<\/jats:sub>\n                      group than in the N and NE\n                      <jats:sub>1<\/jats:sub>\n                      groups during the 48\u2009h postoperative period (\n                      <jats:italic>p<\/jats:italic>\n                      &lt; 0.05).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>\n                      The combination of nalbuphine (2\u2009mg\u2009kg\n                      <jats:sup>\u22121<\/jats:sup>\n                      ) and esketamine (0.5\u2009mg\u2009kg\n                      <jats:sup>\u22121<\/jats:sup>\n                      ) effectively relieves postsurgical pain, reduces the incidence of postoperative PCIA use, and lowers the incidence of adverse events after LC.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Trial Registration<\/jats:title>\n                    <jats:p>ClinicalTrials.gov identifier: ChiCTR2400088373<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1155\/prm\/5086518","type":"journal-article","created":{"date-parts":[[2026,3,9]],"date-time":"2026-03-09T03:07:12Z","timestamp":1773025632000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Appropriate Combination of Nalbuphine Combined With Esketamine for Weakly Opioid Anesthesia in Postlaparoscopic Cholecystectomy Analgesia: A Randomized Controlled Trial"],"prefix":"10.1155","volume":"2026","author":[{"given":"Mengyun","family":"Zhang","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hao","family":"Wu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Han","family":"Zheng","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jing","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jiaxuan","family":"Wang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-2146-5325","authenticated-orcid":false,"given":"Hong","family":"Luo","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7160-5400","authenticated-orcid":false,"given":"Heng","family":"Yang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2026,3,3]]},"reference":[{"key":"e_1_2_11_1_2","volume-title":"Laparoscopic Cholecystectomy. 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