Effects of a continuous rate infusion of butorphanol in isoflurane-anesthetized horses on cardiorespiratory parameters, recovery quality, gastrointestinal motility and serum cortisol concentrations

PURPOSE: To assess the cardiorespiratory parametes, recovery, gastrointestinal motility and serum cortisol concentrations in horses anesthetized with isoflurane with or without a continuous rate infusion (CRI) of butorphanol for orchiectomy. METHODS: Twelve adult, intact, male horses weighing 332 ± 55 kg were included in the study. Xilazine was administered as premedication. Anesthesia was induced with ketamine and midazolam and maintained with isoflurane. Butorphanol (0.025 mg kg-1 bolus) or an equivalent volume of saline (0.9%) was given intravenously followed by a CRI of butorphanol (BG) (13 µg kg-1 hour-1) or saline (CG). Cardiorespiratory variables were recorded before (T0) and every 15 minutes for 75 minutes after the start of infusion. Serum cortisol concentration was measured at T0 and 60 minutes, and 30 minutes and 19 hours after the horse stood up. Recovery from anesthesia was evaluated using a scoring system. Gastrointestinal motility was evaluated before anesthesia and during 24 hours after recovery. RESULTS: There were no significant differences between groups in cardiopulmonary variables, or recovery scores or serum cortisol concentrations. A reduction in gastrointestinal motility was recorded for 60 minutes in BG. CONCLUSIONS: Continuous rate infusion of butorphanol in horses anesthetized with isoflurane did not adversely affect the cardiopulmonary variables monitored, or recovery scores. A small but statistically significant reduction in gastrointestinal motility occurred in the butorphanol group. .

Cateterismo posterior do plexo braquial em cão: estudo radiológico e avaliação de três protocolos anestésicos na duração do bloqueio motor e sensitivo / Posterior catheterization of the brachial plexus: radiological study and evaluation of three anesthetic protocols in motor and sensory block duration

Avaliou-se a eficiência do cateterismo posterior do plexo braquial em cães para promover bloqueio motor e sensitivo, por meio de três protocolos anestésicos. Foram utilizados nove cães, machos e fêmeas, sem distinção de raça e idade, com peso variando de 6 a 15kg, distribuídos em três grupos de três animais por grupo. Após a confirmação do correto posicionamento do cateter pela via posterior do plexo braquial por meio do exame radiográfico, foram aplicadas as medicações de acordo com os grupos. No grupo 1, a solução anestésica de bupivacaína 0,5% sem vasoconstrictor, na dose de 2mg.kg-1, foi usada isoladamente. No grupo 2, a solução anestésica de bupivacaína foi associada ao butorfanol na dose de 0,25mg.kg-1 . No grupo 3, o fentanil, na dose de 0,005mg.kg¹, foi associado à solução anestésica de bupivacaína. Não houve diferença estatística significante entre os grupos. Observou-se que a duração dos bloqueios motor e sensitivo foi clinicamente maior no grupo 2. O cateterismo posterior do plexo braquial permite a aplicação de fármacos mais próximos do plexo nervoso, promovendo analgesia complementar nos membros anteriores.

We evaluated the efficiency of the posterior brachial plexus catheterization in dogs to promote motor and sensory block using three anesthetic protocols. We used nine dogs, males and females, without distinction of race and age, weighing 6 to 15kg which were divided into three groups of three animals per group. After confirming the correct positioning of the catheter through the posterior brachial plexus through radiographic examination, the medications were administered according to the groups. In group 1 the anesthetic bupivacaine 0.5% without a vasoconstrictor dose of 2mg.kg-1 was used alone. In group 2 the anesthetic bupivacaine was associated with butorphanol at a dose of 0.25mg.kg-1. In group 3, the fentanyl dose was associated with 0.005mg.kg-1 anesthetic bupivacaine. There was no statistically significant difference between groups. It was observed that the duration of sensory and motor block was clinically higher in group 2. The posterior brachial plexus catheterization allows the application of drugs closer to the nerve plexus promoting additional analgesia in the forelimbs.

Can you stop this shivering, doctor?

Postoperative shivering and feeling of cold associated with it is rated as worse than pain by some patients. It has been a problem not only after general anesthesia, but also during and after spinal anesthesia. This editorial compliments an original article in this issue of 'Anesthesia, Pain and Intensive Care' on comparison of three different drugs for the treatment of postoperative shivering, and draws attention towards pathogenesis of shivering and its control. Shivering is not a point in time event and its cessation with pharmacological intervention does not guarantee against its recurrence

Butorphanol premedication to facilitate invasive monitoring in cardiac surgery patients before induction of anaesthesia.

Cannulations (peripheral vein, radial artery and jugular vein) performed for invasive monitoring before induction of anaesthesia in cardiac surgery patients may be associated with stress and anxiety. The efficacy and safety of butorphanol premedication was assessed in setting up of invasive monitoring. The study was a prospective, randomized, double blind, placebo controlled one with 70 patients undergoing elective cardiac surgery. In group-1 patients (n = 35) (placebo) intramuscular saline was administered 1-2 hours before the surgery in equivalent volume to butorphanol. In group-2 (n = 35) butorphanol (1, 1.5 and 2 mg for three body weight groups < 40 kg, 41-60 kg and> 60 kg, respectively) was administered 1-2 hours before surgery. Observer blinded for medication recorded the sedation score, pupil size and pain after each cannulation using visual analogue score (VAS). Student's 't' test and Chi-square test for proportions, Mann-Whitney test for non-parametric data was carried out. The median pain score of cannulation in group-2 (butorphanol) in the hand (10 mm) and neck (20 mm) were significantly (P < 0.05) lower than group-1 (placebo) patients (hand = 30 mm and neck = 40 mm). Pain during neck cannulation was significantly (P < 0.05) reduced (VAS < 30 mm) in patients with the pupil size of < 2.5 mm. Since the pain during neck cannulation was more than pain during hand cannulations in both the groups, we conclude that the intensity of pain depends also upon the site of cannulation. Besides the analgesic effect of butorphanol, its sedative effect helped to effectively decrease the pain during neck cannulation in conscious patients.

A comparison of haemodynamic response with pethidine vs. butorphanol in open cholecystectomy cases.

OBJECTIVE: The present study was undertaken to compare the haemodynamic responses with pethidine vs. Butorphanol intraoperatively in open cholecystectomy cases in KMCTH. METHOD: In this randomized study, all together 40 patients undergoing routine cholecystectomy surgery were included. Group A received Pethidine 1 mg/kg and Group B received Butorphanol 0.04 mg/kg intraoperatively. Heart rate and blood pressure were recorded before injection of the drug, after injection, before intubation, after intubation, before skin incision, after incision, before extubation and after extubation data analysis was done using independent sample t test. RESULT: Our study showed no statistical significance in haemodynamic responses with either pethidine or Butorphanol in open cholecystectomy cases. CONCLUSION: Both drugs appear equally good analgesics in our study.

Study of the possible effect of butorphanol or nalbuphene on some hepatorenal functions in the rabbit

Thirty male rabbits were used in this study, they were divided equally to 3 groups, to investigate the effect of repeated daily intramuscular administration of butorphanol or nalbuphene for 4 weeks on some hepatorenal functions. Each drug belonged to the narcotic analgesic group, commonly used; however, their real effect on some body physiological functions still unclear. This study indicated that both drugs induced a severe degree of hepatorenal injury. These actions were evident by increased tremendously aspartate aminotransferase, alanine aminotransferase, serum alkaline phosphatase, serum albumin, blood urea and serum creatinine. Also, the total serum proteins have been reduced. These effects announce that the easy common use of such drugs should be revised; also investigation of the hepatorenal functions should be done before their use

Efectividad y eficacia de Butorfanol NS versus Buprenorfina SL en el tratamiento del dolor postoperatorio / Efficacy and effectively of Butorphanol NS versus Buprenorphine SL in the treatment of acute postoperative pain

Se realizo un estudio prospectivo, abierto, para comparar la seguridad y eficacia de los tratamientos analgésicos de Butorfanol por vía intranasal (n=52) y Buprenorfina sublingual (n=48) en el manejo del dolor postoperatorio por un período de 72 horas. Se incluyeron en el estudio a pacientes hombres y mujeres de 18 a 60 años. El dolor se evaluó con escalas analógica visual y verbal, además se investigaron la escala de mejoría, los signos vitales, saturación de oxígeno por oximetria de pulso y la incidencia de eventos adversos. Ambos grupos tuvieron disminuciones importantes en las puntuaciones del dolor y tuvieron evoluciones similares. La puntuación en la escala de mejoría se incremento en los dos grupos y también tuvo un desarrollo similar. La presión diastólica fue menor en el grupo de Butorfanol a lo largo del estudio mientras que el resto de los signos vitales fue similar en ambos grupos. Los pacientes en el grupo de Butorfanol tuvo mayores niveles de saturación de oxígeno a lo largo del estudio. Un mayor porcentaje de pacientes en el grupo de Butorfanol tuvo sedación a lo largo del estudio y el resto de los eventos adversos fue parecido en ambos grupos. Se concluye que butorfanol por vía intranasal es una buena opción para el tratamiento del dolor postoperatorio

Transnasal butorphanol a new method for operative pain relief in low abdominal gynecological operations

30 female patients of ASA [American Society of Anesthesiologists] physical status I and II scheduled for lower abdominal gynecological surgery, were studied in a comparative prospective trial to compare the efficacy of transnasal and intravenous butorphanol for postoperative pain relief. The patients were divided randomly into two groups. Group I [15 patients] received 2 mg transnasal butorphanol, while group II [15 patients] received 2 mg intravenous butorphanol. The drug in both groups was given when the pain score reached 7. Pain was evaluated at 10, 30 and 60 minutes and then hourly till the pain returned to pre-drug level using the visual analogue scale [2]. For the patients in group I arterial blood gases were measured both preoperatively and after 30 minutes of drug administration to monitor any effect on respiration. For the same group, ECG was monitored continuously and arterial blood pressure and heart rate were measured at the same intervals as pain score. Also, level of consciousness was noted. The study showed significant pain relief for transnasal butorphanol which was comparable for the intravenous route in both efficacy and onset of action, while the duration of analgesia was significantly longer for the transnasal route than the intravenous route. The most frequent side effect was somnolence 80% of patients

Histopathological changes in the ovaries and uteri of female mice after chronic adminstration of morphine and butorphanol tartrate [stadol]

This work was done to study the drastic effects of narcotics on female genital system. Morphine and stadol, the two widely used narcotics in medical fields, were used in this study. They were injected intraperitoneally twice daily for ten days to adult female non- pregnant mice. It was observed that both drugs caused histological changes in the ovaries of treated animals in the form of decrease in the number of primary follicles with increase in the number of atretic follicles and suppression of maturation to Graffian follicles. In addition, both morphine and stadol administration caused histological changes in the uteri of treated mice. These changes included thinning of uterine wall, the endometrial glands are scarce, the endometrial stroma is loose and the myometrium showed marked atrophied thin muscles. The histopathological changes in the ovaries and uteri were more marked in morphine treated animals than in stadol treated group

Possible role of certain neurotransmitters of the monoamine type on butorphanol tartrate-induced physical dependence in mice

Brain monoamines were spectrophotofluorometrically determined during the appearance of butorphanol tartrate withdrawal symptoms in addict adult male mice. The animals were rendered addict by daily administration of the drug for 12 successive days in gradually increasing doses, starting from 1mg/kg and up to 15 mg/kg body weight. Such animals when deprived from butorphanol tartrate, showed after 24 hours severe syndrome consisting of writhing, teeth chattering, ptosis, tachycardia, tremors, and marked nervous hyperexcitability. The animals were decapitated at that time for the determination of their brain contents of dopamine, norepinephrine and serotonin. Compared with a parallel group injected with normal saline and used as control, there was a significant increase in dopamine and norepinephrine contents in brain amounting to 53 and 220%, respectively. On the other hand, no change in brain serotonin content was observed. The results of this work point to a probable role for brain dopamine and norepinephrine but not for serotonin on the induction of butorphanol tartrate withdrawal symptoms in addict adult male mice