Abstract
BackgroundButorphanol, a synthetic opioid partial agonist analgesic, has been widely used to control perioperative pain. However, the ideal dose and availability of butorphanol for gastrointestinal (GI) endoscopy are not well known. The aim of this study was to evaluated the 95% effective dose (ED95) of butorphanol and sufentanil in GI endoscopy and compared their clinical efficacy, especially regarding the recovery time.MethodsThe study was divided into two parts. For the first part, voluntary patients who needed GI endoscopy anesthesia were recruited to measure the ED95 of butorphanol and sufentanil needed to achieve successful sedation before GI endoscopy using the sequential method (the Dixon up-and-down method). The second part was a double-blind, randomized study. Two hundred cases of painless GI endoscopy patients were randomly divided into two groups (n = 100), including group B (butorphanol at the ED95 dose) and group S (sufentanil at the ED95 dose). Propofol was infused intravenously as the sedative in both groups. The recovery time, visual analogue scale (VAS) score, hand grip strength, fatigue severity scores, incidence of nausea and vomiting, and incidence of dizziness were recorded.ResultsThe ED95 of butorphanol for painless GI endoscopy was 9.07 μg/kg (95% confidence interval: 7.81–19.66 μg/kg). The ED95 of sufentanil was 0.1 μg/kg (95% CI, 0.079–0.422 μg/kg). Both butorphanol and sufentanil provided a good analgesic effect for GI endoscopy. However, the recovery time for butorphanol was significantly shorter than that for sufentanil (P < 0.05, group B vs. group S:21.26 ± 7.70 vs. 24.03 ± 7.80 min).ConclusionsButorphanol at 9.07 μg/kg was more effective than sufentanil for GI endoscopy sedation and notably reduced the recovery time.Trial registrationChinese Clinical Trail Registry (Registration number # ChiCTR1900022780; Date of Registration on April 25rd, 2019).
Highlights
Butorphanol, a synthetic opioid partial agonist analgesic, has been widely used to control perioperative pain
Butorphanol is a kappa receptor agonist, which has the advantages of light respiratory depression, stable hemodynamics, a rapid onset, and a moderate effective duration [5], and it may be a more suitable intraoperative and postoperative analgesic for painless GI endoscopy
Butorphanol can be safely applied as a maternal analgesic, especially for pregnant women with pre-eclampsia and chronic hypertension, it dose not cause severe fluctuations in blood pressure [7]
Summary
Butorphanol, a synthetic opioid partial agonist analgesic, has been widely used to control perioperative pain. The ideal dose and availability of butorphanol for gastrointestinal (GI) endoscopy are not well known. The aim of this study was to evaluated the 95% effective dose (ED95) of butorphanol and sufentanil in GI endoscopy and compared their clinical efficacy, especially regarding the recovery time. The stomach and intestine are mainly innervated by the sympathetic and parasympathetic nervous systems [3] and the kappa receptor agonist is found at higher concentrations in the spinal cord is involved in relieving visceral pain [4]. Butorphanol is a kappa receptor agonist, which has the advantages of light respiratory depression, stable hemodynamics, a rapid onset, and a moderate effective duration [5], and it may be a more suitable intraoperative and postoperative analgesic for painless GI endoscopy. It is imperative that the optimal butorphanol dose that produces analgesia and minimizes side effects during outpatient sedation is found
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
