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Butorphanol tartrate: 2. Safety and efficacy in balanced anaesthesia

  • Allen B. Dobkin
  • Hernando Y. Arandia
  • Peter H. Byles
  • Benjamin F. Africa
  • Frank S. Caruso
  • Robert J. Noveck
Article

Summary and Conclusions

After premedication with diazepam and antisialogogues, butorphanol tartrate was used with thiopentone and pancuronium to induce surgical anaesthesia. The induction was smooth in all cases. Nitrous oxide (65 per cent) was used with supplementary small doses of butorphanol tartrate and pancuronium to maintain satisfactory conditions for major abdominal operations in 53 consenting patients. Respiration was invariably controlled with a mechanical respirator. Blood pressure was slightly elevated, pulse rate was stable, and the electrocardiogram was essentially unchanged (lead II) in the majority of patients.

Recovery of adequate respiration was uneventful after reversal of the residual effects of pancuronium. Neostigmine and atropine were the reversal agents. Two patients were given naloxone as well, to reverse excessive drowsiness and respiratory depression apparently due to butorphanol tartrate.

The incidence of other side-effects, such as nausea and vomiting, was not excessive. Amnesia for surgical events was complete in all cases and most of the patients were pleased with the anaesthetic management.

Since butorphanol tartrate provides satisfactory analgesia for major surgery, is available synthetically, has a low propensity to addiction, and has little or no effect on the cardiorespiratory system or on liver and kidney function, we recommend further trial of this compound when a parenteral form of balanced anaesthesia is desired.

Keywords

Naloxone Tartrate Thiopentone Pancuronium Recovery Room 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Résumé

Après une prémédication avec diazepam, atropine ou scopolamine, le tartrate de butorphanol a été utilisé avec le thiopentone et 1e pancuronium pour induire l’anes-thésie. Celle-ci, dans les 53 cas étudiés, a été maintenue avec du protoxyde d’azote et de petites doses supplémentaires de tartrate de butorphanol et de pancuronium. Dans tous les cas, la respiration était contrôlée mécaniquement. La tension artérielle était légèrement augmentée. La fréquence cardiaque est demeurée stable et l’électrocardiogramme n’était pas modifié dans la majorité des patients. Le retour à une respiration adéquate a été obtenu après neutralisation des effets du pancuronium par néostigmine et atropine; la naloxone a été employée chez deux patients pour renverser une somnolence marquée et une dépression respiratoire probablement secondaire au tartrate de butorphanol.

L’incidence d’effets secondaires, tels nausée ou vomissement, était basse. Une amnésie de la procédure chirurgicale entière a été confirmée chez tous les patients. En raison au niveau d’analgésie qu’il procure, de sa faible tendance à produire de l’accoutumance et de son peu d’influence sur les systèmes cardiorespiratoire, hépatique et rénal, nous recommandons l’essai du tartrate de butorphanol quand une forme parentérale d’anesthésie balancée est désirée.

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Copyright information

© Canadian Anesthesiologists 1976

Authors and Affiliations

  • Allen B. Dobkin
    • 1
    • 2
  • Hernando Y. Arandia
    • 1
    • 2
  • Peter H. Byles
    • 1
    • 2
  • Benjamin F. Africa
    • 1
    • 2
  • Frank S. Caruso
    • 1
    • 2
  • Robert J. Noveck
    • 1
    • 2
  1. 1.Department of AnesthesiologyState University of New YorkSyracuseUSA
  2. 2.Upstate Medical CenterState University HospitalSyracuseUSA

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