THE URODYNAMIC EFFECTS OF INTRAVENOUS OPIOIDS AND KETOPROFEN IN HUMANS

We used a double-blind design to study urodynamic changes induced by m u-agonists (fentanyl, morphine), a partial mu-agonist antagonist (bupr enorphine), a putative CL-antagonist, K-agonist (nalbuphine), and keto profen, an injectable nonsteroidal antiinflammatory drug. Men (20-55 y r old) were randomly assigned to receive one of the following IV befor e anesthesia for endoscopic extraction of a ureteral stone: 10 mg of m orphine, 0.3 mg of buprenorphine, 0.35 mg of fentanyl, 20 mg of nalbup hine, 100 mg of ketoprofen, or 10 mt of 0.9% sodium chloride. The urod ynamic study consisted of cystometry followed by urethral pressure pro file. Measurements were taken before the TV infusion of drugs and 15 m in thereafter. Statistical comparisons were performed by using analysi s of variance with repeated measurements (P < 0.05). Ketoprofen and sa line did not induce any urodynamic changes. Opioids altered bladder se nsations, and the residual volume after voiding increased, except afte r morphine. Detrusor contraction decreased only after the administrati on of fentanyl and buprenorphine. Some patients could not micturate af ter receiving morphine, fentanyl, and buprenorphine. Compliance and ur ethral pressures did not change with any drug. This study suggests tha t ketoprofen and nalbuphine are useful analgesics in terms of their ur odynamics. Implications: We compared the urodynamic effects of opioids and ketoprofen used as analgesics in surgical patients. In contrast t o ketoprofen, opioids altered urodynamics. The opioid nalbuphine had n o effect on detrusor contraction. This study suggests that ketoprofen and nalbuphine are useful analgesics in terms of their urodynamics.