Hu J, Chen S, Zhu M, et al. - Researchers sought to determine how nalbuphine affects remifentanil-induced hyperalgesia (RIH, a paradoxical phenomenon that may increase sensitivity to painful stimuli) during laparoscopic cholecystectomy. They grouped 96 patients into four as follows: 0.4 μg/kg/min of remifentanil with 0.2 mg/kg of nalbuphine (HRNA), 0.4 μg/kg/min of remifentanil with saline (HRSA), 0.1 μg/kg/min of remifentanil with 0.2 mg/kg of nalbuphine (LRNA), and 0.1 μg/kg/min of remifentanil with saline (LRSA). They observed reduced pain thresholds on the inner forearm in the HRSA group vs the HRNA, LRNA, and LRSA groups at 24 h after surgery. At 24 h after surgery, reduction in pain thresholds on the peri-incisional area occurred in the HRSA group vs HRNA, LRNA, and LRSA groups. The HRSA group required more sufentanil postoperatively than the HRNA group during the first 3 h and second 3 h. Also greater consumption of postoperative sufentanil was reported in the LRSA group than in the LRNA group during the first 3 h and second 3 h. These findings support the possible effectiveness of preemptive nalbuphine in ameliorating postoperative hyperalgesia induced by high-dose remifentanil in patients undergoing laparoscopic cholecystectomy.