Avaliação cardiorrespiratória e de sedação da associação de dexmedetomidina-butorfanol-midazolam ou detomidina-butorfanol-midazolam em catetos (Pecari tajacu) / Cardiorespiratory and sedation evaluation of the combination of dexmedetomidine-butorphanol-midazolam or detomidine butorphanol-midazolam in collared peccaries (Pecari tajacu)

A presente pesquisa comparou os efeitos cardiorrespiratórios, hemogasométricos e sedativos da associação midazolam (0,41mg/kg) e butorfanol (0,31mg/kg) acrescida de detomidina (157µg/kg) (DTMB) ou dexmedetomidina (36µg/kg) (DXMB) em catetos. Catetos adultos (n=20) foram distribuídos em dois grupos, DTMB ou DXMB. As variáveis (FC, f, PAM, SpO2, EtCO2 e TR) foram avaliadas após aplicação dos fármacos. A sedação foi avaliada por meio de escala analógica visual, relaxamento muscular, postura e resposta auditiva. Foi realizada ANOVA, seguida de teste t pareado (paramétricos) e teste de Mann-Whitney rank-sum test (não paramétricos), com P<0,05. Não foi observada diferença estatística entre os grupos para o período de latência. Observou-se diferença significativa entre grupos para as variáveis f, PAM e SpO2, com maiores valores para DTMB, e EtCO2, com maiores valores para DXMB. Os dois grupos apresentaram redução da FC e da concentração de lactato, bem como aumento da concentração de bicarbonato. A SpO2 permaneceu abaixo de 90%, durante todo o período experimental, nos dois grupos estudados. Os animais dos dois grupos apresentaram sedação profunda e relaxamento muscular máximo. Conclui-se que os dois protocolos testados proporcionaram adequada sedação, podendo ser indicados para contenção química de catetos adultos.(AU)

The study compared the cardiorespiratory, hemogasometric and sedative effects of the combination of midazolam (0.41mg/kg) and butorphanol (0.31mg/kg) plus detomidine (157µg/kg) (DTMB) or dexmedetomidine (36µg/kg) (DXMB) in collared peccaries. Collared peccaries (n= 20) were divided into two groups, either DTMB or DXMB. The variables (FC, f, PAM, SpO2, EtCO2 and TR) were evaluated after application of the drugs. Sedation was assessed by visual analogue scale, muscle relaxation, posture and auditory response. ANOVA followed by paired t-test (parametric) and Mann Whitney Rank Sum Test (non-parametric) with P< 0.05 were performed. No statistical difference was observed for the latency period. A significant increase was observed between groups for the variables f, PAM and SpO2 with higher values for DTMB and EtCO2 with higher values for DXMB. The two groups presented a reduction in HR and lactate concentration, and an increase in bicarbonate concentration. SpO2 remained below 90% throughout the experiment in both groups. The animals of the two groups presented deep sedation and maximum muscle relaxation. It is concluded that the two protocols tested provided adequate sedation and could be indicated for chemical containment of collared peccaries.(AU)

Evaluation of intranasal oxygen supplementation in mules anesthetized with the combination of ketamine, butorphanol, and guaifenesin / Avaliação da suplementação intranasal de oxigênio em muares anestesiados com a associação de cetamina, butorfanol e éter gliceril guaiacólico

Hypoxemia is a major complication of field anesthesia and no studies regarding this occurrence in mules has been done. Thus, the aim of this study was to evaluate intranasal oxygen supplementation (IOS) in mules (Equus caballus x Equus asinus) anesthetized with ketamine/butorphanol/guaifenesin combination. For this, we used six male, adult mules (322±29kg) which underwent premedication (MPA) with 0.2mg/kg of midazolam intramuscularly after 15 minutes, 0.02mg/kg detomidine IV 5 minutes after, induction IV with combination of ketamine (2mg/mL), butorphanol (22.5mg/mL), and guaifenesin (50mg/mL) (K/B/G) until lateral decumbency. Maintenance was done with the same anesthetic combination. The animals were submitted twice to the protocol described above, 20 days apart, forming two groups. CG: MPA, induction (0.92±0.24mL/kg (mean±SD)), and maintenance (2.2±0.2mL/kg/h) without SIO; TG: MPA, induction (0.98±0.17mL/kg), and maintenance (2.3±0.4mL/kg/h) with IOS flow 40mL/kg/h. During anesthesia arterial blood was collected every 20 minutes (T0, T20, T40, and T60) for blood gas analysis. Data analyzed by ANOVA followed by the Bonferroni test. P<0.05 was considered significant. Hypoxemia of the animals in the CG in periods (59±5; 55±5; 53±7; 49±8) with lower averages than the TG (160±4, 115±34, 92±25, 81±19) was observed, demonstrating that IOS increases PaO2 avoiding the occurrence of hypoxemia.(AU)

A hipoxemia é uma das principais complicações da anestesia a campo, e em muares não existem estudos a respeito dessa ocorrência. Assim, objetivou-se avaliar a suplementação intranasal de oxigênio (SIO) em muares (Equus caballus x Equus asinus) anestesiados com cetamina/butorfanol/guaifenesina associados. Para isso, foram utilizados seis muares, macho e adultos (322±29kg), submetidos à medicação pré-anestésica (MPA) com 0,2mg/kg de midazolam por via intramuscular, após 15 minutos, 0,02mg/kg de detomidina por via intravenosa, após cinco minutos, indução com administração intravenosa da associação de cetamina (2mg/mL), butorfanol (22,5 µg/mL) e guaifenesina (50mg/mL) em solução de glicose a 5% (C/B/G) até o animal assumir o decúbito lateral. A manutenção foi realizada com a mesma associação anestésica. Os animais foram submetidos duas vezes ao protocolo descrito anteriormente, com intervalo de 20 dias, formando dois grupos experimentais. GC -MPA, indução (0,92±0,24mL/kg (média±DP)) e manutenção (2,2±0,2mL/kg/h) sem SIO; GT - MPA, indução (0,98±0,17mL/kg) e manutenção (2,3±0,4mL/kg/h) com SIO, fluxo de 40mL/kg/h. Durante a anestesia, foi colhido sangue arterial a cada 20 minutos (T0, T20, T40 e T60) para hemogasometria. Os dados foram analisados pela ANOVA, seguidos pelo teste de Bonferroni. Valores de P<0,05 foram considerados significativos. Foi observada hipoxemia (PaO2<60mmHg) dos animais no GC nos tempos avaliados (T0= 59±5; T20= 55±5; T40= 53±7; T60= 49±8), com médias menores que as do GT, (160±4; 115±34; 92±25; 81±19, respectivamente), o que demonstrou que a suplementação intranasal de oxigênio aumenta a PaO2, evitando a ocorrência de hipoxemia.

Efeitos de dois protocolos de sedação sobre as variáveis bioquímicas em gatos / Effects of two sedation protocols in biochemistry variables in cats

A utilização de protocolos de sedação como auxílio na contenção de felinos para realização de coletas de sangue é de grande importância, porém a utilização de alguns fármacos pode alterar resultados e a interpretação deles. Por outro lado, a contenção física pode gerar intenso estresse, especialmente em felinos, o que também pode interferir nos resultados. Este estudo teve como objetivo avaliar exames de bioquímica clínica sob o uso de contenção física e química em gatos submetidos a dois protocolos de sedação. Foram utilizados 50 gatos, 26 fêmeas e 24 machos, sem raça definida, submetidos a contenção física e, imediatamente após, a dois protocolos de sedação, DB (dexmedetomidina 5µg/kg e butorfanol 0,3mg/kg) e DBC (dexmedetomidina 5µg/kg, butorfanol 0,3mg/kg e cetamina 3mg/kg), aplicados por via intramuscular. Amostras de sangue foram coletadas após a contenção física e, em seguida, após o uso de um dos protocolos de sedação. Foram avaliados: ureia, creatinina, alaninoaminotransferase (ALT), fosfatase alcalina, proteína sérica total (PST), albumina, globulinas, colesterol, triglicérides, cálcio, magnésio e cloretos de amostras de soro, lactato e glicose de amostras de plasma fluoretado. Foi encontrada diferença estatística entre grupos para albumina, triglicérides, PST e colesterol, com maiores valores sendo encontrados no grupo DBC. Entre momentos, houve diferença para colesterol e fosfatase alcalina, com maiores valores no momento contenção física somente no grupo DBC. Já a glicose teve maiores valores após a sedação em ambos os grupos. O estudo revelou que o uso destes protocolos implica restrições para alguns parâmetros bioquímicos aqui estudados e que suas interpretações devem ser avaliadas cuidadosamente.(AU)

The use of sedation protocols to assist in the restraint of cats to perform blood collections is of great importance, but the use of some drugs can alter the results and interpretation. Moreover, the physical restraint may generate intense stress, especially in animals of the feline species, which may also interfere with the results. This study aimed to evaluate examinations of clinical biochemistry in the use of physical restraint and chemistry in cats subjected to two sedation protocols. We used 50 cats, 26 females and 24 males, of mixed-breed, who underwent physical restraint and immediately after underwent two sedation protocols, DB (dexmedetomidine 5µg / kg and 0.3mg butorphanol / kg) and DBC (dexmedetomidine 5µg / kg butorphanol 0.3mg / kg ketamine and 3mg / kg), applied intramuscularly. Blood samples were taken after physical restraint and then after the use of one of the sedation protocols. The following parameters were evaluated: urea, creatinine, alanine aminotransferase (ALT), alkaline phosphatase (ALP), total serum protein (TP), albumin, globulin, cholesterol, triglycerides, calcium, magnesium and chloride in serum samples, and lactate and glucose in fluoride plasma samples. Statistical difference was found between groups for albumin, triglycerides, TP and cholesterol with higher values being found in the DBC group. A statistical difference between moments was found for cholesterol, and ALP with higher values in physical restraint only in the DBC group. Glucose had greater values after sedation for both groups. The study revealed that the use of these protocols implies restrictions on some biochemical parameters studied here, and that their interpretations should be evaluated carefully.(AU)

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. .

Effects of continuous rate infusion of butorphanol in isoflurane-anesthetized calves

PURPOSE: To assess the hemodynamic changes and bispectral index (BIS) following administration of a continuous rate infusion (CRI) of butorphanol in isoflurane-anesthetized calves. METHODS: Eight calves weighing 110 ± 12 kg were included in the study. Anesthesia was induced with 5% isoflurane in O2 delivered via face mask and maintained with end-tidal concentration of 1.4%. IPPV was set to a peak inspiratory airway pressure of 15 cmH2O and respiratory rate of six breaths minute-1. Forty minutes after the start of anesthetic maintenance, 0.1 mg kg-1butorphanol was administered intravenously, followed by a CRI of 20 µg kg-1 minute-1. Hemodynamic variables and BIS were recorded before butorphanol administration (T0), and at 10, 20, 40 and 80 minutes following the CRI. Anesthesia was discontinued after the last recording and the calves were allowed to recover. The time to sternal recumbency (SRE) and standing (ST) were evaluated. RESULTS: There were no significant differences between the moments in all hemodynamic variables and BIS. The time to SRE and ST was 9 ± 5 and 14 ± 7 minutes, respectively. CONCLUSION: The continuous rate infusion did not produce clinically relevant changes in hemodynamic or bispectral index values compared to baseline in mechanically ventilated and unstimulated calves anesthetized at 1.4% isoflurane. .

Dose sparing of induction dose of propofol by fentanyl and butorphanol: a comparison based on entropy analysis

The induction dose of propofol is reduced with concomitant use of opioids as a result of a possible synergistic action. The present study compared the effect of fentanyl and two doses of butorphanol pre-treatment on the induction dose of propofol, with specific emphasis on entropy. Three groups of 40 patients each, of the American Society of Anaesthesiologistsphysical status I and II, were randomized to receive fentanyl 2 microg/kg [Group F], butorphanol 20 microg/kg [Group B 20] or 40 microg/kg [Group B 40] as pre-treatment. Five minutes later, the degree of sedation was assessed by the observer's assessment of alertness scale [OAA/S]. Induction of anesthesia was done with propofol [30 mg/10 s] till the loss of response to verbal commands. Thereafter, rocuronium 1 mg/kg was administered and endotracheal intubation was performed 2 min later. OAA/S, propofol induction dose, heart rate, blood pressure, oxygen saturation and entropy [response and state] were compared in the three groups. Data was analyzed using ANOVA test with posthoc significance, Kruskal-Wallis test, Chi-square test and Fischer exact test. A P<0.05 was considered as significant. The induction dose of propofol [mg/kg] was observed to be 1.1 +/- 0.50 in Group F, 1.05 +/- 0.35 in Group B 20 and 1.18 +/- 0.41 in Group B 40. Induction with propofol occurred at higher entropy values on pre-treatment with both fentanyl as well as butorphanol. Hemodynamic variables were comparable in all the three groups. Butorphanol 20 microg/kg and 40 microg/kg reduce the induction requirement of propofol, comparable to that of fentanyl 2 microg/kg, and confer hemodynamic stability at induction and intubation

Influência do butorfanol sobre os períodos de latência e de ação da ropivacaína pela via peridural na ovariossalpingo-histerectomia em cadelas / Influence of butorphanol on latency and duration of ropivacaine epidural anesthesia for ovariosalpingohysterectomy in bitches

Avaliaram-se os períodos de latência e de duração do efeito do butorfanol associado à ropivacaína aplicados pela via peridural e a possibilidade de uso dessa associação como protocolo anestésico para realização de ovariossalpingo-histerectomia (OSH) em cadelas. Utilizaram-se 16 cadelas pré-medicadas com acepromazina e midazolam compondo dois grupos: no grupo 1 (n=8) aplicou-se ropivacaína isolada (0,3mL/kg) e no grupo 2 (n=8), butorfanol (0,1mg/kg) e ropivacaína (até o volume de 0,3mL/kg), pela via peridural. Consideraram-se nove momentos (M): M0 - animal sem anestesia, M1 - 15 minutos após medicação pré-anestésica; M2 - 30 minutos após a aplicação peridural; M3, M4 e M5 - correspondentes ao início do procedimento e ao pinçamento dos pedículos esquerdo e direito, respectivamente; M6 - ligadura da cérvix uterina; e M7 e M8 - início da laparorrafia e fim da sutura de pele, respectivamente. Foram avaliados os períodos de latência e ação do bloqueio, além da viabilidade de realização do procedimento cirúrgico por meio do bloqueio efetuado. O que recebeu ropivacaína + butorfanol apresentou sedação pronunciada e permitiu a realização de OSH em 75 por cento dos animais, sem indução anestésica. Não houve diferença entre os grupos quanto aos períodos de latência e duração. A associação do butorfanol à ropivacaína proporcionou bloqueio anestésico compatível com a realização de OSH e período de latência curto, com duração de efeito suficiente para o procedimento cirúrgico.

The periods of latency and duration of butorphanol associated with ropivacaine used via epidural, and this combination as anesthetic protocol for carrying out ovariosalpingohysterectomy (OSH) in bitches were evaluated. Sixteen animals pre-medicated with acepromazine and midazolam were used composing two groups that received: 1 (n=8) ropivacaine (0.3mL/kg) and 2 (n=8) butorphanol (0.1mg/kg) and ropivacaine (up to the volume of 0.3ml/kg) via epidural. Nine moments were studied: M1 - 15 minutes after pre-anesthetic medication; M2 - 30 minutes after the epidural medication; M3, M4, and M5 - at the beginning of surgery and at clamping left and right pedicles, respectively; M6 - at ligation of the uterine cervix; and M7 and M8 - at laparorhaphy and end of skin suture, respectively. Periods of latency and blocking the action of random double-covert manner were evaluated as well as the feasibility of carrying out the surgery performed by the blockade. It was observed that the group receiving ropivacaine + butorphanol allowed the execution of OSH in 75 percent of animals without the need for anesthesia. There was no statistical difference between the periods of latency and duration. It was concluded that the combination of butorphanol to ropivacaine provides, in bitches, block compatible with the implementation of OSH with short period of latency and duration of effect sufficient for the surgical procedure.

The efficacy and safety of low dose epidural butorphanol on postoperative analgesia following cesarean delivery.

Butorphanol is considered an effective and safe analgesic after cesarean delivery but is associated with profound dose-dependent sedation. Somnolence may cause hindrance in early mother-baby interaction. This study was designed to assess the analgesic efficacy and to monitor side-effects of low doses (0.5 mg and 0.75 mg) of epidural butorphanol with bupivacaine compared to bupivacaine alone in parturients following cesarean delivery. One hundred and twenty parturients (American Society of Anesthesiologists physical status 1 and 2) undergoing cesarean delivery were allocated into three groups: group 1 received epidural 0.125% bupivacaine while group 2 and 3 received an additional 0.5 mg and 0.75 mg butorphanol respectively. A combined spinal, epidural technique was used. Spinal anaesthesia was used for surgery. The epidural route was used for postoperative analgesia with the study drug. Onset, duration and quality of analgesia, lowest visual analogue scales (VAS) score, and side effects were noted. The onset and duration of analgesia in group 2 (4.1+/-2.6 min and 202.4+/-62.8 min) and group 3 (4.0+/-2.5 min and 192.3+/-69.1 min) were significantly different (P<0.01) from group 1 (6.6+/-2.7 min and 145.7+/-89.6 min). The quality of analgesia in terms of time to first independent movement and satisfactory VAS were statistically better (P<0.01) in group 2 (3.9+/-0.3 hour and 8.1+/-0.1 mm) and group 3 (3.8+/-0.4 hour and 8.1+/-0.9 mm) than in group 1 (5.2+/-0.4 hour and 6.3+/-1.3 mm). The incidence of sedation was 5% in all the three groups. A lower dose of epidural butorphanol with bupivacaine produces a significantly earlier onset, longer duration and better quality of analgesia than bupivacaine does.

Comparative study of epidural administration of 10 ml of 0.1% bupivacaine with 2 mg butorphanol and 10 ml of 0.25% plain bupivacaine for analgesia during labor.

Analgesia during labor provided by two epidural drug regimens was compared in a double blind, randomized, prospective study. Group A (n = 12) received 10 ml bolus doses of 0.1% bupivacaine with butorphanol 2 mg while Group B (n = 8) received 10 ml of 0.25% plain bupivacaine. The objectives of this study was to compare, between the quality of an epidural labor analgesia using initial loading dose of 0.1% bupivacaine and 2 mg butorphanol with a initial loading dose of 0.25% bupivacaine. In Group A, incidence of motor block was 8.3% and that of prolong 2nd stage of labor was 16.7%, both were decreased in comparison with Group B, although they were not statistically significant. Hemodynamic variables were stable and no adverse neonatal and maternal outcome was observed in both groups. Addition of butorphanol to bupivacaine may be safe alternative to reduce motor block and decrease prolong 2nd stage for epidural labor analgesia.

Efeitos cardiovasculares e neuroendócrinos do butorfanol e da buprenorfina em cães anestesiados pelo desfluorano / Cardiovascular and neuroendocrine effects of butorphanol and buprenorphine in dogs anesthetized with desflurane

Avaliaram-se os efeitos do butorfanol e da buprenorfina sobre variáveis cardiovasculares e neuroendócrinas em cães anestesiados com desfluorano, utilizando-se 30 cães adultos, machos e fêmeas, distribuídos em três grupos denominados grupo butorfanol (GBT), grupo buprenorfina (GBP) e grupo-controle (GCO). A anestesia foi induzida com propofol (8mg/kgIV) e nos animais intubados administrou-se desfluorano (1,5CAM). Após 30 minutos, nos cães do GBT, aplicou-se butorfanol (0,4mg/kgIM); nos do GBP, buprenorfina (0,02mg/kgIM); e nos do GCO, solução de NaCl a 0,9 por cento (0,05ml/kgIM). Avaliaram-se: freqüência cardíaca; pressões arteriais sistólica, diastólica e média; débito cardíaco; pressão venosa central; cortisol; hormônio adrenocorticotrópico; noradrenalina; e glicose. As colheitas dos dados foram feitas aos 30 minutos após o início da administração do desfluorano (M0), 15 minutos após a administração do opióide ou placebo (M15), e a cada 15 minutos após M15 (M30, M45, M60 e M75). Para a avaliação neuroendócrina utilizaram-se os momentos M-30 (antes da administração dos fármacos), M0, M15 e M45. Na freqüência cardíaca houve diferença entre M0 e M15 (129 e 111bat/min) em GBT, e entre M0 e M30 (131 e 112bat/min) em GBP. Na pressão arterial média, a diferença foi entre M0 (86mmHg) e todos os momentos que se seguiram (todos os valores foram menores que 72mmHg), em GBT. A pressão arterial diastólica foi menor em todos os momentos (<53mmHg) quando comparada com a do M0 (67mmHg), em GBT. Na pressão arterial sistólica, a diferença foi entre M0 e M15 e M30 (112 versus 93 e 94mmHg, respectivamente) em GBT. A inclusão dos opióides determinou discreta redução nos parâmetros cardiovasculares, enquanto o desfluorano interferiu na função neuroendócrina elevando os níveis plasmáticos de glicose.

The effects of butorphanol and buprenorphine on cardiovascular and neuroendocrine variables in dogs anesthetized with desflurane were studied. Thirty adult healthy, males and females, mongrel dogs were distributed in three groups denominated butorphanol group (BTG), buprenorphine group (BPG) and control group (COG). The anesthetic induction was done using propofol (8mg/kg, IV), and immediately, the dogs were intubated and submited to desflurane anaesthesia (1.5 MAC). After 30 minutes, the BTG animals received butorphanol (0.4mg/kg IM), the BPG animals buprenorphine (0.02mg/kg IM) and the COG animals saline solution at 0.9 percent (0.05 ml/kg IM). Heart rate; systolic, diastolic and mean arterial blood pressures; cardiac output; venous central pressure; cortisol; ACTH; noradrenalin; and glucose were measured. The measurements were recorded at 30 minutes after beginning the inhalatory anaesthesia (M0) and at 15 minutes after opioid or saline administration (M15). Also a serial measurements were carried out in 15-minute intervals after M15 (M30, M45, M60 and M75). For neuroendocrine evaluation measurements were recorded before desflurane administration (M-30), and at M0, M15 AND m45. For heart rate there were differences between M0 and M15 (129 and 111 beats/min) in BTG, and between M0 and M30 (131 and 112 beats/min), in BPG. For mean arterial blood pressure there were differences between M0 (86mmHg) and all the recorded measurements (all measurements were lower than 72mmHg), in BTG. All recorded diastolic arterial blood pressures were lower than 53mmHg and different of the recorded measure M0 (67mmHg), in BTG. For systolic arterial blood pressure there were differences between M0 and M15 and M30 (112 vs 93 and 94mmHg, respectively), in BTG. Opioids administration determined discrete reduction in cardiovascular parameters while desflurane caused alterations in neuroendocrine function, increasing plasmatic levels of glucose.

Efficacy of caudal butorphanol.

OBJECTIVE: To evaluate the efficacy of butorphanol with or without bupivacaine for caudal epidural anesthesia in children undergoing infraumbilical surgery. METHODS: Sixty ASA physical status I and II patients of either sex aged 1-10 yr were randomized to one of three groups. Group L received 1 ml/kg of 0.25% bupivacaine; Group B received 1 ml/kg of 25 microg/kg butorphanol diluted in normal saline; and Group LB received 1 ml/kg of 25 microg/kg butorphanol in combination with 0.25% bupivacaine, in caudal epidural anesthesia. Hemodynamic variables (HR and MAP) and respiratory rate were monitored in all patients. Sedation score, pain score and requirement of rescue analgesia were recorded at preset time intervals alongwith post-operative complications. RESULTS: There was no difference among the groups regarding sedation scores, requirement of rescue analgesia and post-operative complications. Mean duration of analgesia was maximum in group BL (14.5 +/- 3.5 hr, P<0.001), than in group L (8.8 +/- 4.8 hr) and group B (6.8 +/- 2.9 hr). CONCLUSION: The addition of 25 microg/kg butorphanol to bupivacaine resulted in superior analgesia with a longer period compared with caudal bupivacaine and butorphanol alone, without an increase of side effects.

Cardiovascular and pulmonary effects of romifidine and butorphanol combination in horses

The effects of romifidine (60µg/kg) and butorphanol (40µg/kg) combination were studied in eight horses. The parameters were measured before (T0) and 10 (T1), 15 (T2), 30 (T3), 40 (T4) and 65 (T5) minutes after sedation. Heart rate, cardiac output and cardiac index decreased significantly post-treatment. A significant increase was present in pulmonary arterial pressure, pulmonary arterial wedge pressure, central venous pressure and systemic vascular resistance values at post-treatment period. Systolic, mean and diastolic arterial pressures, stroke index and pulmonary vascular resistance did not change significantly. Respiratory rate, mixed venous saturation of oxygen, mixed venous oxygen content and oxygen delivery index decreased significantly post-treatment. Arterial partial pressure of oxygen, arterial saturation of oxygen, mixed venous partial pressure of oxygen, arterial oxygen content, arteriovenous oxygen content difference, oxygen consumption index, oxygen extraction ratio, pH and arterial bicarbonate did not change significantly. The partial pressure of carbon dioxide increased significantly 40 minutes post-treatment. The romifidine and butorphanol combination produced cardiovascular depression similar to those reported with romifidine used alone.

Os efeitos da associação de romifidina (60 µg/kg) com butorfanol (40 µg/kg) i.v. foram avaliados em oito eqüinos. Os parâmetros foram avaliados antes da sedação e 10 (T0), 15 (T2), 30 (T3), 40 (T4) e 65 (T5) minutos após. Os valores da freqüência cardíaca, débito cardíaco e índice cardíaco apresentaram redução significativa após a sedação. Um aumento significativo após a sedação foi observado nos valores da pressão da artéria pulmonar, pressão de oclusão de artéria pulmonar, pressão venosa central e índice de resistência vascular sistêmica. Os valores da pressão arterial sistólica, média e diastólica, índice sistólico e resistência vascular pulmonar não apresentaram alterações significativas. Houve redução significativa nos valores da freqüência respiratória, saturação de oxigênio no sangue venoso misto, conteúdo de oxigênio no sangue venoso misto e índice de oferta de oxigênio após a sedação. Os valores da pressão parcial de oxigênio, saturação arterial de oxigênio, pressão parcial de oxigênio no sangue venoso misto, conteúdo arterial de oxigênio no sangue arterial, diferença arteriovenosa de oxigênio, índice de consumo de oxigênio, taxa de extração de oxigênio, pH e bicarbonato plasmático no sangue arterial não apresentaram alterações significativas. Um aumento significante da pressão parcial de dióxido de carbono ocorreu aos 40 minutos após a sedação. A combinação de romifidina e butorfanol levou a depressão cardiovascular semelhante a relatada com o uso de romifidina isoladamente.

Oral midazolam and oral butorphanol premedication.

OBJECTIVE: To evaluate the efficacy of oral midazolam and oral butorphanol for their sedative analgesic effects in children. METHODS: Sixty children, aged 2 to 10 yrs, of ASA physical status I and II, scheduled for surgical procedures of 1 to 2 hrs duration were randomized to one of the two groups. Group I: children received midazolam 0.5 mg/kg orally and Group II: children received butorphanol 0.2 mg/kg orally. Score of the children was assessed every 5 minutes till the induction of anesthesia. Intraoperative and postoperative analgesic requirement was recorded along with postoperative recovery and complications. RESULTS: The groups were identical regarding the patient's characteristics, hemodynamic variables, duration of surgery and awakening time. Less time was required for the onset and time of maximum sedation in the butorphanol group (p<0.05). Sedation scores were similar among the groups at all time intervals, while the scores were higher in the butorphanol group at the time of induction (p<0.05). Less number of children required intraoperative and postoperative rescue analgesia in the butorphanol group (p<0.05). Statistically significant difference was found among the groups in respect to complete amnesia (50% in group I vs 80% I group II, p<0.05) and recollection (40% in group I vs 10% in group II, p<0.05). CONCLUSION: Oral butorphanol is comparable to oral midazolam in children but analgesia along with sedation is an additional advantage which makes it better than midazolam without a significant increase in side effects.

Avaliação algimétrica por estímulo nociceptivo térmico e pressórico em cães pré-tratados com levomepromazina, midazolam e quetamina associados ou não ao butorfanol ou buprenorfina / The algimetry evaluation for thermic and pressoric nociceptive stimulus in pre treated dogs with methotrimeprazine, midazolam and ketamine associated or not with butorphanol or buprenorphine

OBJETIVO: Quantificar a dor em cães sob anestesia dissociativa através de estímulo térmico e pressórico e o período hábil de dois analgésicos opióides. MÉTODOS: Empregaram-se 30 cães alocados em três grupos (n=10), onde os animais de GI receberam levomepromazina e midazolam associado na mesma seringa à quetamina. Os animais de GII receberam o mesmo tratamento de GI porém associado ao butorfanol e por fim os animais de GIII receberam o mesmo tratamento de GI associando-se a buprenorfina. Procedeu se a avaliação paramétrica rotineira, empregando-se, entretanto, a termoalgimetria mensurada em ºC em média de 52ºC e a pressoalgimetria em kg. RESULTADOS: Na termoalgimetria houve diferença significativa em GI nos momentos M0 e M1,e em M4 e M5. Em GII houve diferença em M0, M1, M5 e M6. Em GIII houve diferença entre momentos M0 e M1. Na pressoalgimetria houveram diferenças em GI em diferentes momentos: M0, M2 e M3. Em GII observaram-se diferenças em todos os momentos. Em GIII observaram-se diferenças em M0 e M9. Ocorreram diferenças entre os grupos, sendo o M2 de GII menor que GI e GIII. Já em M4 e M5 de GIII demonstrou-se maior que GI e GII. E na avaliação dos períodos observou-se um período de latência significativamente maior em GI, porém com período hábil e de recuperação menor em relação à GII e GIII. Já a recuperação do tônus postural foi maior em GIII seguido de GII e finalmente de GI. CONCLUSAO: O método empregado para mensuração do estímulo álgico foi eficiente, observando-se um período hábil analgésico de 3 horas para o butorfanol e de 6 horas para a buprenorfina.

Comparison of equipotenet doses of butorphanol and pethidine for intraoperative analgesia, postoperative requirement and its adverse effects

This double blind randomized study was conducted in forty ASA I and ASA II patients aged 20 to 60 years, scheduled for total abdominal hysterectomy. Butorphanol 20 micrograms/ Kilogram proved to be an adequate analgesic supplement to nitrous oxide, oxygen and relaxant anaesthesia with 0.5% halothane, for total abdominal hysterectomy surgery in the majority of our patients. The patients remained stable intraoperatively, excessive cardiovascular response to surgical stimuli, were sufficiently suppressed and the technique provided satisfactory analgesia in the postoperative period. Recovery of consciousness and spontaneous ventilation presented no problem and the incidence of side effects was no different from pethidine

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

Tartrato de butorfanol como suplemento de la anestesia general balanceada / Butorfanol as a suplement of general anesthesia

Se presenta un estudio prospectivo en 40 pacientes (N=40), los cuales fueron evaluados en la fase transoperatoria, administrándose Anestesia General Balanceada, teniendo como base el Halotano siendo dividido éste estudio en dos grupos de 20 pacientes cada uno (N=20). El grupo 1, correspondió a los pacientes cada uno (N=20). El grupo 1, correspondió a los pacientes a los cuales se les administró Butorfanol a dosis de 3.71 ñ 0.54 mg, con una edad de 33.95 ñ 13.15 años y un peso de 61.07 ñ 8.55 kg. El grupo 2, correspondió a los pacientes a los cuales se les administró Nalbufina a razón de 19.2 ñ 4.18 mg, con una edad de 35.35 ñ 12.83 años, y un peso de 61.85 ñ 9.32 kg. El comportamiento hemodinámico fue analizado mediante t de Student con P< 0.05, encontrándose diferencia significativa para la tensión arterial sistólica transoperatoria (95 ñ 10.82, y 110.5 ñ 6.86 Hg respectivamente). La concentración alveolar mínima del Halotano fue analizado por t de Student con P< 0.01, encontrándose diferencia significativa (1.24 ñ 0.24, y 1.54 ñ 0.27 respectivamente). No se presentaron complicaciones en ambos grupos. Concluimos que el Tartrato de Butorfanol puede ser un recurso en las técnicas de Anestesia General Balanceada