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Respiratory Effects of Nalbuphine and Butorphanol in Anesthetized Patients

Received from the Department of Anesthesiology, Veterans Administration Medical Hospital, Seattle, Washington.

Abstract

A double-blind, randomized study was conducted in 16 patients who were anesthetized with 50% nitrous oxide in oxygen and given either 0.17 mg/kg butorphanol or 0.86 mg/kg nalbuphine, and whose respiratory depression was assessed by the response of minute ventilation to increasing carbon dioxide concentrations. The slopes of the carbon dioxide ventilatory response curves [VE/CO₂(L-min^–1·%CO₂^–1)] were 7.45 ± 1.17 with nalbuphine and 2.42 ± 0.56 with butorphanol. Butorphanol caused significantly (P < 0.025) greater respiratory depression than nalbuphine. The results of this study caution against the indiscriminate use of butorphanol in the perianesthetic setting.

Key Words: ANALGESICS—butorphanol, nalbuphine • VENTILATION—analgesics and

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