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Butorphanol Improves CO₂ Response and Ventilation after Fentanyl Anesthesia

University of Washington, Seattle, Washington.

Abstract

We have determined that the mixed agonist-antagonist narcotic, butorphanol, improves CO, response and ventilation after fentanyl anesthesia. A tentative dosage range has been established. Twenty-two patients were anesthetized with isoflurane, nitrous oxide, and fentanyl, which was continuously infused throughout the study. Postoperatively three 1-mg doses of butorphanol were administered IV. Blood pressure, heart rate, plasma epinephrine and norepinephrine concentrations, and pain intensity were essentially unchanged after butorphanol. Most of the improvement in breathing occurred after the first 1-mg dose. Mean respiratory rate increased from 7.8 ± 5.0 to 11.0 ± 4.8 min (P 0.005), tidal volume increased from 469 ± 302 to 844 ± 390 ml (P 0.005), minute ventilation increased from 4.32 ± 2.97 to 8.51 ± 3.14 L/min (P 0.005), and the slope of the ventilatory response to CO₂ increased from 0.36 ± 0.37 to 0.90 ± 0.80 L·min ¹·mm Hg ¹(P 0.05). Resting PaCO₂ decreased from a baseline of 57.8 11.1 to 51.7 ± 5.12 mm Hg (P 0.05) after the third dose.

Key Words: ANALGESICS—fentanyl, butorphanol • ANTAGONISTS, narcotic—butorphanol • VENTILATION—CO₂ response curves

This article has been cited by other articles:

				H. R. Garner, T. F. Burke, C. D. Lawhorn, J. M. Stoner, and W. D. Wessinger Butorphanol-Mediated Antinociception in Mice: Partial Agonist Effects and Mu Receptor Involvement, J. Pharmacol. Exp. Ther., September 1, 1997; 282(3): 1253 - 1261. [Abstract] [Full Text]

Anesthesia & Analgesia® is published for the International Anesthesia Research Society® by Lippincott Williams & Wilkins with the assistance of Stanford University Libraries' HighWire Press®. Copyright 2006 by the International Anesthesia Research Society. Online ISSN: 1526-7598   Print ISSN: 0003-2999