Additional droperidol, not butorphanol, augments epidural fentanyl analgesia following anorectal surgery.
OBJECTIVE
To examine the effects of additional droperidol or butorphanol to epidural fentanyl infusion on postsurgical analgesia.


METHODS
Prospective, randomized, single blinded clinical study.


METHODS
University-affiliated medical center.


METHODS
60 ASA physical status I and II patients undergoing anorectal surgery by one surgeon.


METHODS
Patients were randomly allocated to the following groups according to the medication that was continuously administered into the epidural space: 1) Group C (n = 20) received 0.4 mg fentanyl in 40 ml of 0.125% bupivacaine; 2) Group D (n = 20) received 2.5 mg droperidol and 0.4 mg fentanyl in 40 ml of 0.125% bupivacaine; and 3) Group B (n = 20) received 2 mg butorphanol and 0.4 mg fentanyl in 40 ml of 0.125% bupivacaine over 24 hours postoperatively.


RESULTS
Postsurgical analgesia and the incidence of fentanyl-related complications, such as nausea/vomiting, somnolence, pruritus, and respiratory depression, were assessed for 24 hours postoperatively. At 16 and 24 hours after surgery, 75% of patients in Group D reported no pain versus 35% in Group C (p < 0.05). In addition, the overall visual analogue scale examined at 24 hours was significantly lower in Group D than that in Group C (22 +/- 17 mm vs. 44 +/- 22 mm, respectively; p < 0.05). Simultaneously, the incidence of postoperative nausea/vomiting was lower in Group D compared with Group C (20% vs. 60%; p < 0.05). On the other hand, butorphanol did not modify the analgesic effects or complications of epidural fentanyl infusion.


CONCLUSIONS
In this study population, additional droperidol, not butorphanol, improved postsurgical analgesia accompanied by less incidence of nausea/vomiting during epidural fentanyl administration.
Kotake
Y
Y
Department of Anesthesiology, Tachikawa Kyosai Hospital, Tokyo, Japan.
Matsumoto
M
M
Ai
K
K
Morisaki
H
H
Takeda
J
J
D000759:Adjuvants, Anesthesia / Q000009:adverse effects / Q000627:therapeutic use*; D001003:Anal Canal / Q000601:surgery*; D015360:Analgesia, Epidural; D000701:Analgesics, Opioid / Q000009:adverse effects / Q000627:therapeutic use*; D000704:Analysis of Variance; D000779:Anesthetics, Local / Q000009:adverse effects / Q000627:therapeutic use; D002045:Bupivacaine / Q000009:adverse effects / Q000627:therapeutic use; D002077:Butorphanol / Q000009:adverse effects / Q000627:therapeutic use*; D004329:Droperidol / Q000009:adverse effects / Q000627:therapeutic use*; D005260:Female; D005283:Fentanyl / Q000009:adverse effects / Q000627:therapeutic use*; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D010149:Postoperative Pain / Q000188:drug therapy*; D020250:Postoperative Nausea and Vomiting / Q000139:chemically induced; D011446:Prospective Studies; D011537:Pruritus / Q000139:chemically induced; D012007:Rectum / Q000601:surgery*; D012119:Respiration / Q000187:drug effects; D016037:Single-Blind Method; D012894:Sleep Stages / Q000187:drug effects
D000759:Adjuvants, Anesthesia; D000701:Analgesics, Opioid; D000779:Anesthetics, Local; D004329:Droperidol; D002077:Butorphanol; D005283:Fentanyl; D002045:Bupivacaine