Nalbuphine Can Relieve Opioid-Induced Urine Retention

Case report describes relief for patient with hepatocellular carcinoma treated with hydromorphone
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TUESDAY, Sept. 4, 2018 (HealthDay News) -- Nalbuphine can relieve opioid-induced urine retention, according to a case report published online Sept. 4 in the Annals of Internal Medicine.

Abdisamad M. Ibrahim, M.D., from the Southern Illinois University School of Medicine in Springfield, and colleagues describe how nalbuphine helped manage opioid-induced urine retention in a 59-year-old man with a history of alcoholic cirrhosis who was hospitalized for worsening right-sided abdominal pain. The patient was diagnosed with portal vein thrombosis and hepatocellular carcinoma.

The authors note that after treatment of pain with hydromorphone, the patient developed new-onset urine retention that did not respond to α1-blockers and required intermittent urinary catheterization. The patient found the intervention inconvenient and declined placement of a permanent catheter. A literature search revealed use of nalbuphine for reversal of postoperative urine retention without loss of pain control. The patient consented to this treatment, and 10 mg nalbuphine was administered intravenously. During the first six hours after receiving the drug, the patient voided 850 mL, and pain remained controlled. On ultrasonography, bladder volume was 77 mL one day later. The patient required no additional nalbuphine treatment before being discharged to hospice the next day.

"We believe that clinicians should consider offering nalbuphine to patients with opioid-induced urine retention that does not respond to α1-blockers who prefer to stop bladder catheterization," the authors write.

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