Low-dose butorphanol alleviates remifetanil-induced hyperalgesia in patients undergoing laparoscopic cholecystectomy.
OBJECTIVE
To evaluate the effects of low-dose butorphanol on hyperalgesia induced by high-dose remifetanil in patients undergoing laparoscopic cholecystectomy.


METHODS
Randomized double-blind clinical trial.


METHODS
Intraoperative.


METHODS
Seventy-five patients scheduled for laparoscopic cholecystectomy were enrolled.


METHODS
Randomly allocated into 3 groups, low dose of remifentanil (LR) group and high dose of remifentanil (HR) group received low (0.1μg kg(-1) min(-1)) or high (0.3μg kg(-1) min(-1)) doses of remifentanil, respectively, and butorphanol combined with remifentanil (BR) group received remifentanil (0.3μg kg(-1) min(-1)) and butorphanol (0.2μg/kg).


METHODS
The visual analog scale scores and cumulative consumption of fentanyl were recorded.


RESULTS
Visual analog scale scores were significantly higher in the HR group than in the LR and BR groups (P<.001). The dose of intravenously given fentanyl was significantly higher in the HR group than in the LR and BR groups (P<.001). In addition, the HR group showed a significantly higher cumulative consumption of fentanyl during 5 to 8 hours after the operation (P<.001).


CONCLUSIONS
A high dose of remifentanil induces postoperative hyperalgesia, which could be prevented by a continuous intravenous administration of a low dose of butorphanol.
Department of Anesthesia, The Second Affiliated Hospital of Xuzhou Medical College, Xuzhou 221000, People's Republic of China. Electronic address: mjkong@126.com.
Mingjian
M
Kong
Department of Anesthesia, The Second Affiliated Hospital of Xuzhou Medical College, Xuzhou 221000, People's Republic of China.
Li
L
Yang
Department of Anesthesia, The Second Affiliated Hospital of Xuzhou Medical College, Xuzhou 221000, People's Republic of China.
Jing
J
Li
Department of Anesthesia, The Second Affiliated Hospital of Xuzhou Medical College, Xuzhou 221000, People's Republic of China.
Zheng
Z
Zhong
Department of Anesthesia, The Second Affiliated Hospital of Xuzhou Medical College, Xuzhou 221000, People's Republic of China.
Yanqiang
Y
Cheng
Department of Anesthesia, Jiangyin Hospital, Medical College of Southeast University, No. 163, Shoushan Rd, Jiangyin 214400, People's Republic of China.
Zhen
Z
Wu
Department of Anesthesia, Jiangyin Hospital, Medical College of Southeast University, No. 163, Shoushan Rd, Jiangyin 214400, People's Republic of China.
Ran
R
Guo
D000328:Adult; D000701:Analgesics, Opioid / Q000008:administration & dosage / Q000009:adverse effects*; D000768:Anesthesia, General / Q000009:adverse effects / Q000379:methods; D002077:Butorphanol / Q000008:administration & dosage / Q000627:therapeutic use*; D017081:Cholecystectomy, Laparoscopic; D004311:Double-Blind Method; D005260:Female; D005283:Fentanyl / Q000008:administration & dosage / Q000627:therapeutic use*; D006801:Humans; D006930:Hyperalgesia / Q000139:chemically induced / Q000517:prevention & control*; D008297:Male; D008875:Middle Aged; D009292:Narcotic Antagonists / Q000008:administration & dosage / Q000627:therapeutic use*; D010147:Pain Measurement; D010149:Postoperative Pain / Q000139:chemically induced / Q000517:prevention & control*; D010880:Piperidines / Q000008:administration & dosage / Q000009:adverse effects*; D017473:Receptors, Opioid, kappa / Q000819:agonists / Q000037:antagonists & inhibitors; D017450:Receptors, Opioid, mu / Q000819:agonists / Q000037:antagonists & inhibitors; D000077208:Remifentanil
D000701:Analgesics, Opioid; D009292:Narcotic Antagonists; D010880:Piperidines; D017473:Receptors, Opioid, kappa; D017450:Receptors, Opioid, mu; D000077208:Remifentanil; D002077:Butorphanol; D005283:Fentanyl
Butorphanol; Remifentanil; laparoscopic cholecystectomy; ĸ-Opioid receptors; μ-Opioid receptor