Comparison of ED95 of Butorphanol and Sufentanil for gastrointestinal endoscopy sedation: a randomized controlled trial

Zhu, Xiaona; Chen, Limei; Zheng, Shaoling; Pan, Linmin

doi:10.1186/s12871-020-01027-5

Cited by 14 publications

(17 citation statements)

References 25 publications

(25 reference statements)

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“…In this study, the incidence of propofol injection pain in groups B, C, and D was significantly lower than that in group A ( χ = 57.303, P < 0.05), and the incidence of mild pain in group D was also significantly lower than that in group B ( P < 0.05), indicating that prophylactic intravenous injection of 5–10 μg/kg butorphanol 10 min before the operation can effectively reduce the incidence of propofol injection pain. The highest concentration, i.e., 10 μg/kg butorphanol, showed the maximum analgesic effect, which is compatible with the previous study that the ED95 of butorphanol for the anesthesia of gastrointestinal endoscopy was 9.07 μg/kg [ 19 ]. As an agonist of the kappa receptor, butorphanol is suggested to produce a certain degree of sedation, which could lead to adverse reactions such as dizziness and drowsiness during the recovery period, affected the discharge score, and reduced the diagnostic and treatment efficiency.…”

Section: Discussionsupporting

confidence: 90%

Anesthetic effect of different doses of butorphanol in patients undergoing gastroscopy and colonoscopy

Sun

et al. 2021

BMC Surg

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Background This study aimed to investigate the anesthetic effect of butorphanol with different doses in patients undergoing gastroscopy and colonoscopy. Methods 480 patients undergoing gastroscopy and colonoscopy were recruited and randomly divided into four groups to receive different doses of butorphanol (Group A = 2.5 μg/kg, Group B = 5 μg/kg, Group C = 7.5 μg/kg and Group D = 10 μg/kg). Butorphanol was administered 5 min before propofol infusion. The primary outcome was the incidence of body movement. Secondary outcomes were postoperative recovery time, length of stay in the Post-Anesthesia Care Unit (PACU), the total dose of propofol, and the incidence of intraoperative hypoxemia, propofol injection pain, cough, postoperative nausea and vomiting, drowsiness, and dizziness. Results The incidence of body movement and the dose of propofol in Group C and D were lower than those in Group A and B (P < 0.05). The incidence and intensity of propofol injection pain and the incidence of cough in Group B, C, and D were lower than those in Group A (P < 0.05). The length of stay in PACU and the incidence of postoperative drowsiness and dizziness were higher in Group D than in Group A, B, and C (P < 0.05). Conclusion Intravenous pre-injection of 7.5 μg/kg butorphanol with propofol can be the optimal dosage for patients undergoing gastroscopy and colonoscopy. Trial registration: Trial registration: Chinese Clinical Trial Registry, ChiCTR2000031506. Registered 3 April 2020—Retrospectively registered, http://www.medresman.org.cn.

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Section: Discussionsupporting

confidence: 90%

Anesthetic effect of different doses of butorphanol in patients undergoing gastroscopy and colonoscopy

Sun

et al. 2021

BMC Surg

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“…In addition, the co-administration of propofol with other anesthetics has been shown to reduce the required dose of propofol for targeted anesthesia, and improve patient satisfaction during diagnostic and therapeutic endoscopy[ 11 , 19 - 24 , 29 ]. Considering the various advantages of butorphanol, which are mainly associated with less anesthesia-related AEs ( e.g., respiratory depression, smooth muscle spasm, skin itches, urinary retention, physical and physiological dependence, nausea and vomiting)[ 25 , 26 ], the co-administration of butorphanol with propofol was examined in the present study. The up-and-down sequential method was used to determine the EC50, which is a commonly used measurement to evaluate the potency of a drug.…”

Section: Discussionmentioning

confidence: 99%

“…The advantages of butorphanol include low toxicity and low potential for abuse. Previous studies have revealed that compared to other synthetic opioid analgesic drugs ( e.g., sufentanil), butorphanol has less anesthesia-related AEs, such as respiratory depression, decreased gastrointestinal activity and smooth muscle spasm, itchy skin, urinary retention, physical and physiological dependence, nausea, and vomiting[ 25 , 26 ]. Furthermore, butorphanol has been widely used in anesthesia for patients undergoing gastrointestinal endoscopy.…”

Section: Introductionmentioning

confidence: 99%

Efficacy and safety of propofol target-controlled infusion combined with butorphanol for sedated colonoscopy

Guo¹,

Sun²,

Feng³

et al. 2023

World J Clin Cases

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BACKGROUND Propofol is a short-acting, rapid-recovering anesthetic widely used in sedated colonoscopy for the early detection, diagnosis and treatment of colon diseases. However, the use of propofol alone may require high doses to achieve the induction of anesthesia in sedated colonoscopy, which has been associated with anesthesia-related adverse events (AEs), including hypoxemia, sinus bradycardia, and hypotension. Therefore, propofol co-administrated with other anesthetics has been proposed to reduce the required dose of propofol, enhance the efficacy, and improve the satisfaction of patients receiving colonoscopy under sedation. AIM To evaluate the efficacy and safety of propofol target-controlled infusion (TCI) in combination with butorphanol for sedation during colonoscopy. METHODS In this controlled clinical trial, a total of 106 patients, who were scheduled for sedated colonoscopy, were prospectively recruited and assigned into three groups to receive different doses of butorphanol before propofol TCI: Low-dose butorphanol group (5 μg/kg, group B1), high-dose butorphanol group (10 μg/kg, group B2), and control group (normal saline, group C). Anesthesia was achieved by propofol TCI. The primary outcome was the median effective concentration (EC50) of propofol TCI, which was measured using the up-and-down sequential method. The secondary outcomes included AEs in perianesthesia and recovery characteristics. RESULTS The EC50 of propofol for TCI was 3.03 μg/mL [95% confidence interval (CI): 2.83-3.23 μg/mL] in group B2, 3.41 μg/mL (95%CI: 3.20-3.62 μg/mL) in group B1, and 4.05 μg/mL (95%CI: 3.78-4.34 μg/mL) in group C. The amount of propofol necessary for anesthesia was 132 mg [interquartile range (IQR), 125-144.75 mg] in group B2 and 142 mg (IQR, 135-154 mg) in group B1. Furthermore, the awakening concentration was 1.1 μg/mL (IQR, 0.9-1.2 μg/mL) in group B2 and 1.2 μg/mL (IQR, 1.025-1.5 μg/mL) in group B1. Notably, the propofol TCI plus butorphanol groups (groups B1 and B2) had a lower incidence of anesthesia AEs, when compared to group C. Furthermore, no significant differences were observed in the rates of AEs in perianesthesia, including hypoxemia, sinus bradycardia, hypotension, nausea and vomiting, and vertigo, among group C, group B1 and group B2. CONCLUSION The combined use with butorphanol reduces the EC50 of propofol TCI for anesthesia. The decrease in propofol might contribute to the reduced anesthesia-related AEs in patients undergoing sedated colonoscopy.

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“…One reason is that the patients had minimal discomfort at this dose in our pretest. The other is that 9.07 μg/kg of butorphanol was more effective than sufentanil for gastrointestinal endoscopy sedation and notably reduced the recovery time [ 19 ]. However, Lv Sun and colleagues found that compared with other dosages of butorphanol (2.5, 5, or 10 μg/kg), intravenous preinjection of 7.5 μg/kg of butorphanol with propofol had the lowest incidence of body movement, drowsiness, and dizziness [ 20 ].…”

Section: Discussionmentioning

confidence: 99%

Effect of butorphanol on visceral pain in patients undergoing gastrointestinal endoscopy: a randomized controlled trial

Wang

Liu

et al. 2023

BMC Anesthesiol

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Background Butorphanol slightly influences the respiratory and circulatory systems, has a better effect on relieving the discomfort caused by mechanical traction, and has a low incidence of postoperative nausea and vomiting (PONV). Combined butorphanol and propofol may suppress postoperative visceral pain, which is avoidable in gastrointestinal endoscopy. Thus, we hypothesized that butorphanol could decrease the incidence of postoperative visceral pain in patients undergoing gastroscopy and colonoscopy. Methods This was a randomized, placebo-controlled, and double-blinded trial. Patients undergoing gastrointestinal endoscopy were randomized to intravenously receive either butorphanol (Group I) or normal saline (Group II). The primary outcome was visceral pain after the procedure 10 min after recovery. The secondary outcomes included the rate of safety outcomes and adverse events. Postoperative visceral pain was defined as a visual analog scale (VAS) score ≥ 1. Results A total of 206 patients were enrolled in the trial. Ultimately, 203 patients were randomly assigned to Group I (n = 102) or Group II (n = 101). In total, 194 patients were included in the analysis: 95 in Group I and 99 in Group II. The incidence of visceral pain at 10 min after recovery was found to be statistically lower with butorphanol than with the placebo (31.5% vs. 68.5%, respectively; RR: 2.738, 95% CI [1.409–5.319], P = 0.002), and the notable difference was in pain level or distribution of visceral pain (P = 0.006). Conclusions The trial indicated that adding butorphanol to propofol results in a lower incidence of visceral pain after surgery without noticeable fluctuations in circulatory and respiratory functions for gastrointestinal endoscopy patients. Trial registration Clinicaltrials.gov NCT04477733 (PI: Ruquan Han; date of registration: 20/07/2020).

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Comparison of ED95 of Butorphanol and Sufentanil for gastrointestinal endoscopy sedation: a randomized controlled trial

Cited by 14 publications

References 25 publications

Anesthetic effect of different doses of butorphanol in patients undergoing gastroscopy and colonoscopy

Anesthetic effect of different doses of butorphanol in patients undergoing gastroscopy and colonoscopy

Efficacy and safety of propofol target-controlled infusion combined with butorphanol for sedated colonoscopy

Effect of butorphanol on visceral pain in patients undergoing gastrointestinal endoscopy: a randomized controlled trial

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