Butorphanol premedication improves postoperative lung function and analgesic outcomes in laparoscopic surgery: a...

Area of Science:

• Anesthesiology
• Pulmonary Medicine
• Pharmacology

Background:

• Balancing effective analgesia and pulmonary function preservation is crucial in laparoscopic surgery.
• Butorphanol, a mixed opioid agonist-antagonist, presents potential respiratory and anti-inflammatory benefits.

Purpose of the Study:

• To evaluate the impact of pre-induction butorphanol on intraoperative pulmonary gas exchange in patients undergoing elective laparoscopic surgery.
• To compare the efficacy of low-dose (1 mg) versus high-dose (2 mg) butorphanol against a control group.

Main Methods:

• A prospective, randomized, double-blind, three-arm clinical trial involving 81 patients.
• Patients received either placebo, 1 mg butorphanol, or 2 mg butorphanol intramuscularly 30 minutes before anesthesia.
• Primary outcomes included intraoperative PaO2, PaCO2, and ETCO2; secondary outcomes covered ventilatory mechanics, pulmonary function, inflammation, analgesia, and long-term follow-up.

Main Results:

• The 2 mg butorphanol group demonstrated significant improvements in intraoperative pulmonary gas exchange compared to the control.
• High-dose butorphanol reduced airway pressures, anesthetic needs, and inflammatory markers, while improving postoperative pulmonary function and analgesia.
• The 2 mg group showed superior pulmonary function recovery, quality of life, and reduced chronic pain at 9-month follow-up.

Conclusions:

• Pre-induction butorphanol administration effectively enhances intraoperative pulmonary gas exchange and secondary outcomes in laparoscopic surgery.
• A 2 mg dose of butorphanol provides the most consistent benefits, making it suitable for Enhanced Recovery After Surgery (ERAS) protocols.