Influence of butorphanol on the postoperative remifentanil hyperalgesia

Objective: To evaluate the influence of butorphanol on the postoperative remifentanil hyperalgesia. Methods: A total of 120 cases of patients undergoing laparoscopic resection of uterine fibroids were involved into the research work, which were divided into two groups: study group (n=60) and control group (n=60). About 10 min before the ending of the operation, 20 pg/kg butorphanol in tartaric acid injection were given to the patients in study group, while the equivalent normal saline was given to those in control group. The analgesic and sedative effects within 30 min, 1 h, and 4 h after analepsia were evaluated by visual analogue scale (VAS) and Ramsay sedation score, respectively. The remifentanil and propofol dosages during the operation and the tramadol dosages within 4 h after analepsia between the two groups were compared. The differences of operation duration, recovery time, extubation time, as well as adverse reactions within 4 h after analepsia were compared. Results: According to the intention to treat (ITT) principle; the final cases of study group and control group for evaluation were 58 and 59, respectively. Differences of the remifentanil and propofol dosages during the operation between the two groups were no statistical significance (P>0.05), while the tramadol dosages within 4 h after analepsia had statistically significant difference (P<0.05). The differences of operation duration, recovery time, and extubation time between two groups were not statistically significant (P>0.05). The VAS scores of study group within 30 min, 1 h, and 4 h after analepsia were all lower than those of control group, and the differences were statistically significant (P<0.05). There was no statistically significant difference between the Ramsay scores from two groups within 30 min, 1 h, and 4 h after analepsia (P>0.05). The incidences of nausea and vomiting, shivering, somnolence and dizziness within 4 h after analepsia between two groups were statistically significant (P<0.05). Conclusions: Butorphanol could safely and effectively prevent the postoperative remifentanil hyperalgesia.