Published online Nov 16, 2023. doi: 10.12998/wjcc.v11.i32.7806
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
Postoperative nausea and vomiting (PONV) are common complications after surgery, seriously affects the prognosis of elderly patients for laparoscopic gastrointestinal surgery.
This prospective, double-blind randomized controlled trial aimed to investigate the effect of butorphanol on PONV in this patient population.
Elderly patients (≥ 65 years old) who underwent gastrointestinal laparoscopic surgery.
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.
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.
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.
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).