Randomized Controlled Trial
Copyright ©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Nov 16, 2023; 11(32): 7806-7813
Published online Nov 16, 2023. doi: 10.12998/wjcc.v11.i32.7806
Effect of anesthesia induction with butorphanol on postoperative nausea and vomiting: A randomized controlled trial
Fang Xie, De-Feng Sun, Lin Yang, Zhong-Liang Sun
Fang Xie, De-Feng Sun, Zhong-Liang Sun, Department of Anesthesiology, The First Affiliated Hospital of Dalian Medical University, Dalian 116011, Liaoning Province, China
Lin Yang, Department of Neuroelectrophysiology, The First Affiliated Hospital of Dalian Medical University, Dalian 116011, Liaoning Province, China
Co-first authors: Fang Xie and Lin Yang.
Author contributions: Xie F drafted the manuscript and critically revised the manuscript for important intellectual content; Sun DF approved the final version to be published; Yang L agreement to be accountable for all aspects of the work, ensuring that the questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved; Sun ZL substantial contribution to the conception and design of the study; and all authors read and approved the final manuscript.
Institutional review board statement: The study was approved by the Ethics Committee of the First Affiliated Hospital of Dalian Medical University (PJ-KS-KY-2020-161 [X]).
Clinical trial registration statement: The study is registered in the China Clinical Trial Center (ChiCTR2100045860, 25/04/2021).
Informed consent statement: All participants provided a signed informed consent.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Data sharing statement: The datasets generated and/or analyzed in the study are not publicly available due to the limitations of ethical approval, which involve the patient data and anonymity. However, these are available from the corresponding author on reasonable request.
CONSORT 2010 statement: The authors have read the CONSORT 2010 Statement, and the manuscript was prepared and revised according to the CONSORT 2010 Statement.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: De-Feng Sun, MS, Professor, Department of Anesthesiology, The First Affiliated Hospital of Dalian Medical University, No. 5 Longbin Road, Dalian 116011, Liaoning Province, China. sundefengyl@163.com
Received: August 10, 2023
Peer-review started: August 10, 2023
First decision: August 30, 2023
Revised: October 18, 2023
Accepted: November 9, 2023
Article in press: November 9, 2023
Published online: November 16, 2023
ARTICLE HIGHLIGHTS
Research background

Postoperative nausea and vomiting (PONV) are common complications after surgery, seriously affects the prognosis of elderly patients for laparoscopic gastrointestinal surgery.

Research motivation

This prospective, double-blind randomized controlled trial aimed to investigate the effect of butorphanol on PONV in this patient population.

Research objectives

Elderly patients (≥ 65 years old) who underwent gastrointestinal laparoscopic surgery.

Research methods

Patients were randomly assigned to receive butorphanol (40 μg/kg) or sufentanil (0.3 μg/kg) during anesthesia induction in a 1:1 ratio. The measured outcomes included the incidence of PONV at 48 h after surgery, intraoperative dose of propofol and remifentanil, Bruggrmann Comfort Scale (BCS) score in the postanesthesia care unit (PACU), number of compressions for postoperative patient-controlled intravenous analgesia (PCIA), and time to first flatulence after surgery.

Research results

The results revealed a noteworthy reduction in the occurrence of PONV at 24 h after surgery in the butorphanol group, when compared to the sufentanil group. However, no significant variations were observed between the two groups, in terms of the clinical characteristics, such as the PONV or motion sickness history, intraoperative and postoperative 48-h total infusion volume and hemodynamic parameters, intraoperative dose of propofol and remifentanil, number of postoperative PCIA compressions, time until the first occurrence of postoperative flatulence, and incidence of PONV at 48 h post-surgery. Furthermore, patients in the butorphanol group were more comfortable, when compared to patients in the sufentanil group in the PACU.

Research conclusions

The administration of butorphanol has shown potential in significantly reducing the occurrence of PONV within 24 h after gastrointestinal surgery in elderly patients, and improving the comfort of patients in the PACU.

Research perspectives

Anesthesia induction with butorphanol may reduce the incidence of PONV, especially for some patients with a high risk of PONV (young women, no-smoking, PONV or motion sickness history, high-risk surgeries, such as pelvic surgery, thyroid surgery, strabismus repair, and middle ear surgery).