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Butorphanol premedication improves postoperative lung function and analgesic
outcomes in laparoscopic surgery: a randomized dose-response study
#MMPMID41193998
Yang X
; Wu Z
; Zhuang Y
; Gong T
; Liu Y
; Zhu Y
BMC Anesthesiol
2025[Nov]; 25
(1
): 544
PMID41193998
show ga
PURPOSE: In laparoscopic surgery, balancing effective analgesia with preservation
of pulmonary function remains a clinical challenge. Butorphanol, a ?-opioid
receptor agonist and partial µ-opioid receptor agonist, may offer advantages in
respiratory protection and anti-inflammatory effects. METHODS: This prospective,
randomized, double-blind, three-arm, single-center clinical trial was conducted
at the Affiliated Hospital of Zunyi Medical University. Between June 2021 and
December 2023, a total of 81 patients undergoing elective laparoscopic surgery
were enrolled, including 28 in the control group, 27 in the low-dose butorphanol
group (1 mg), and 26 in the high-dose butorphanol group (2 mg). All patients
received an intramuscular injection of the assigned study drug 30 min before
anesthesia induction. The primary outcome was intraoperative pulmonary gas
exchange, including arterial partial pressure of oxygen (PaO(2)), arterial
partial pressure of carbon dioxide (PaCO(2)?), and end-tidal carbon dioxide
(ETCO(2)). Secondary outcomes included intraoperative ventilatory mechanics,
perioperative pulmonary function, inflammatory markers, postoperative analgesia,
anesthetic drug consumption, and follow-up outcomes up to 9 months after surgery.
RESULTS: Compared with the control group, butorphanol-particularly at
2 mg-significantly improved intraoperative pulmonary gas exchange. The high-dose
group showed greater benefits in reducing airway pressures and anesthetic
requirements, improving postoperative pulmonary function, suppressing
inflammatory responses, and enhancing analgesic effects. During the 9-month
follow-up, 70 patients completed all assessments, and the high-dose group
consistently demonstrated superior recovery of pulmonary function, better quality
of life, and lower levels of chronic pain. CONCLUSION: Pre-induction butorphanol
enhances intraoperative pulmonary gas exchange and improves secondary outcomes,
with 2 mg showing the most consistent benefits for ERAS protocols. CLINICAL TRIAL
REGISTRATION: The study has been registered with the Chinese Clinical Trial
Registry, registration number: ChiCTR2100047900. Registration date: June 27,
2021. Not retrospectively registered.
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