Journal Article

Low-dose butorphanol alleviates remifetanil-induced hyperalgesia in patients undergoing laparoscopic cholecystectomy

Zhong, Zheng, Yang, Li, Wu, Zhen, Guo, Ran, Kong, Mingjian, Li, Jing, Cheng, Yanqiang

2016

Overview

To evaluate the effects of low-dose butorphanol on hyperalgesia induced by high-dose remifetanil in patients undergoing laparoscopic cholecystectomy. Randomized double-blind clinical trial. Intraoperative. Seventy-five patients scheduled for laparoscopic cholecystectomy were enrolled. 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). The visual analog scale scores and cumulative consumption of fentanyl were recorded. 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). A high dose of remifentanil induces postoperative hyperalgesia, which could be prevented by a continuous intravenous administration of a low dose of butorphanol. •Remifentanil enhances postoperative pain through the activation of mu-opioid receptor.•High dose of remifentanil during laparoscopic cholecystectomy induced postoperative hyperalgesia.•Low dose of butorphanol prevented remifentanil-induced postoperative hyperalgesia.

• Publisher: Elsevier Inc,Elsevier Limited
• Subject: Adult / Analgesics / Analgesics, Opioid - administration & dosage / Analgesics, Opioid - adverse effects / Anesthesia / Anesthesia & Perioperative Care / Anesthesia, General - adverse effects / Anesthesia, General - methods / Butorphanol / Butorphanol - administration & dosage / Butorphanol - therapeutic use / Cholecystectomy / Cholecystectomy, Laparoscopic / Double-Blind Method / Female / Fentanyl - administration & dosage / Fentanyl - therapeutic use / Humans / Hyperalgesia / Hyperalgesia - chemically induced / Hyperalgesia - prevention & control / laparoscopic cholecystectomy / Laparoscopy / Male / Middle Aged / Narcotic Antagonists - administration & dosage / Narcotic Antagonists - therapeutic use / Narcotics / Pain / Pain Measurement / Pain Medicine / Pain, Postoperative - chemically induced / Pain, Postoperative - prevention & control / Patients / Piperidines - administration & dosage / Piperidines - adverse effects / Pruritus / Receptors, Opioid, kappa - agonists / Receptors, Opioid, kappa - antagonists & inhibitors / Receptors, Opioid, mu - agonists / Receptors, Opioid, mu - antagonists & inhibitors / Remifentanil / Skin / Studies / Surgery / Vomiting / ĸ-Opioid receptors / μ-Opioid receptor