Butorphanol tartrate is better than fentanyl for postoperative analgesia after intestinal surgery: A prospective cohort study

Abstract

Background Traditional opioid analgesics act on the μ2 receptors and lead to delayed gastric emptying and weakening of the peristalsis. Butorphanol is an opioid analgesic that has strong excitatory effect on κ receptors, weak μ receptor agonistic and antagonistic activity. This study aimed to compare the effects of butorphanol tartrate and fentanyl on the analgesia and the gastrointestinal motility after intestinal surgery. Method This prospective cohort study was conducted in Zhongnan Hospital of Wuhan University, Wuhan, China from May to September 2017. One hundred and forty six patients admitted to ICU after intestinal surgeries, were divided into fentanyl group and butorphanol group. The fentanyl group continually infused fentanyl with 1ug/kg/h and the butorphanol group continually infused butorphanol with 20ug/kg/h. The analgesics were used until the patients were transfer out of ICU or up to 24 hours. The primary outcome was the time required for the first passage of flatus. The second outcomes included the pain and sedation scores, the incidence of nausea and vomiting, serum motilin concentrations, and the incidence rate of adverse reactions. Results There were 69 patients in butorphanol group and 77patients in fentanyl group. Compared with the fentanyl group, the time required for the first passage of flatus was shorter (69.82 ±18.84 h vs. 79.34 ± 15.69 h, p= 0.0012) and the incidence of nausea (14.9% vs. 29.3%, P=0.013) and vomiting (11.7% vs. 27.3%, P=0.031) was significantly lower in the butorphanol group without any significant difference in analgesic score and sedation score. The serum motilin increase level was significantly higher in butorphanol group [21.36(6.17, 28.47) ng/L vs. 5.56(3.04, 9.81) ng/L, P = 0.034]. Conclusion: In patients undergoing intestinal surgery, butorphanol tartrate allows faster recovery of gastrointestinal function and similar analgesia compared to fentanyl. TRIAL REGESTRITION Chinese Clinical Trial Register (ChiCTR-INR-17011031). Registered on Mar 31th 2017.

Advances in the Use of Butorphanol Tartrate in Postoperative Analgesia after Cesarean Section

“…Published by Francis Academic Press, UK -11-orthopaedic surgeries with high injury irritation and severe postoperative pain, postoperative intravenous self-administered analgesia with bupropion compared with sufentanil has shown good analgesic effects and reduced opioid use, improving the quality of patients' postoperative recovery [23] .…”