Comparison of Butorphanol and Fentanyl for Patient-controlled Epidural Analgesia after Gastrectomy

Abstract

Background: Epidural butorphanol produces effective analgesia with fewer side effects than morphine in obstetric patients. The analgesic efficacy and side effects of epidural butorphanol were compared with epidural fentanyl for patient-controlled epidural analgesia (PCEA) after gastrectomy. Methods: After obtaining patient consent, 75 patients undergoing elective gastrectomy were randomly allocated to epidural butorphanol and epidural fentanyl groups. An epidural catheter was introduced at the T7-8 or T9-10 intervertebral spaces before operation. General anesthesia was maintained with N2O / O2, enflurane and vecuronium. Postop-erative analgesia was provided using a PCEA with either fentanyl 5μg/ml or butorphanol 50μg/ml in a 0.05% bupivacaine solution. When patients first required analgesics after complete recovery of conscious-ness from general anesthesia, a bolus of 5 ml of PCEA solution was initially administered in both groups. The PCEA was set to deliver a bolus of 2 ml, with a lockout interval of 10 min, and no basal infusion. PCEA consumption, pain intensity using a visual analog score (VAS), patient's satisfaction to PCEA, and side effects were evaluated. Results: No significant difference in PCEA consumption, VAS pain score, or patient's satisfaction to PCEA was found between the two groups. The incidence of pruritus in the butorphanol g roup was less than that in the fentanyl group (P ＜ 0.05). Conclusions: PCEA with butorphanol provided similar postoperative analgesia with less pruritus than fentanyl in gastrectomized