Abstract
Butorphanol was compared with fentanyl as the narcotic component of general anaesthesia for ambulatory laparoscopic surgery. This doubleblind, randomized study enrolled 60 healthy women who received equianalgesic doses of fentanyl 1 μg · kg−1 (F, n = 30) or butorphanol 20 μg · kg−1 (B, n = 30) prior to induction of anaesthesia. Tracheal anaesthesia was maintained with nitrous oxide/oxygen, isoflurane, and succinylcholine by infusion, lntraoperatively, patients who received B demonstrated lower pulse rate before and after intubation (P < 0.05, P < 0.01) and lower diastolic blood pressure after intubation (P < 0.01). Anesthesiologists judged the maintenance phase as satisfactory more often with B (P < 0.05). Postoperatively, there were no differences in analgesic need. No major sideeffects occurred in either group. Among minor sideeffects, patients who received B reported postoperative sedation more often, 77% vs 37% (P < 0.01), which occurred during the first 45 min of recovery (P < 0.05). Discharge times were not different. On the first postoperative day, more subjects who received B were satisfied with their anaesthesia experience (P < 0.05). Butorphanol 20 μg · kg−1 is an acceptable alternative analgesic in general anaesthesia for ambulatory laparoscopy.
Résumé
Nous avons comparé les effets du butorphanol à ceux du fentanyl lors de laparoscopies faites en externe. Soixante patientes ont participé à cette étude doubleinsu. Avant l’ induction de l’anesthésie, on leur injectait à litre d’ équivalent analgésique, soit 1 μg · kg−1 de fentanyl (groupe F, n = 30), soit 20 μg · kg−1 de butorphanol (groupe B, n = 30). Après l’ intubation de la trachée, elles respiraient de l’ oxygène, du protoxyde d’ azote et de l’ isoflurane associés à une perfusion de succinylcholine. Les patientes du groupe B avaient un pouls plus lent avant et après l’ intubation (P < 0,05; P < 0,01) de meme qu’ une tension artérielle diastolique plus basse après l’ intubation (P < 0,01). Les anesthésistes ont jugé favorablement la phase de maintien de l’ anesthésie plus souvent chez les patientes du groupe B(P < 0,05). En période postopératoire, les besoins en analgésiques étaient les mêmes dans les deux groupes avec de la sédation qui, quoique plus fréquente dans le groupe B (77 vs 37%; P < 0,01) durait moins de 45 min (P < 0,05). Nous n’avons observe aucun effet secondaire important et la durée du séjour en salle de réveil était semblable chez les groupes F et B. Le lendemain de l’ intervention, les patientes du groupe B cotaient leur anesthésie avec plus de satisfaction (P < 0,05). Lors d’ une anesthésie générale pour fin de laparoscopie en externe, l’ usage de butorphanol est tout à fait acceptable.
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Supported in part by grants from Anaquest, Murray Hill, NJ and from Bristol Laboratories, Evansville, IN, USA.
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Philip, B.K., Scott, D.A., Freiberger, D. et al. Butorphanol compared with fentanyl in general anaesthesia for ambulatory laparoscopy. Can J Anaesth 38, 183–186 (1991). https://doi.org/10.1007/BF03008141
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DOI: https://doi.org/10.1007/BF03008141