Epidural butorphanol-bupivacaine for postoperative analgesia

Abstract

Background and Objectives. Effectiveness and incidence of side effects for epidural butorphanol-bupivacaine combination for postoperative analgesia were examined.
Methods. One hundred and six patients undergoing elective surgery received epidural of 1% lidocaine 3ml and butorphanol 1mg just prior to surgery. Continuous epidural administration of butorphanol-bupivacaine solution was initiated at one hour after skin incision. The solution consisted of 3 or 4mg butorphanol and 60ml of 0.25% bupivacaine, and the infusion rate was 2ml/hour. Patients were allocated to 4 groups accoding to type of surgery received: group U, upper abdominal surgery (n=43); group L, lower abdominal surgery (n=21); group G, gynecological surgery (n=25); and group C, laparoscopic cholecystectomy (n=17). The authors recorded patient's rated pain, nausea, vertigo, pruritis, hypotension, respiratory state, somnolence, and psychic state at 0, 3, 6, 12, 24, and 48 hours after surgery.
Results. Additional analgesics were administered in 12%/5% (at 0/48 hours after surgery) patients in group U, 10%/10% in group L, 24%/36% in group G, and 12%/0% in group C. Sixty-eight percent of the patients in group G and 47% of the patients in group C complained of nausea. Pruritis was reported in only one patient. Somnolence was revealed in about 20% patients.
Conclusions. Epidural butorphanol-bupivacaine provides adequate postoperative analgesia after upper and lower abdominal surgery, but is inadequate after gynecological surgery and laparoscopic cholecystectomy.