Canadian Journal of Anesthesia, Vol 23, 601-608, Copyright © 1976 by Canadian Anesthesiologists' Society

Butorphanol Tartrate: 2. Safety and Efficacy in Balanced Anaesthesia

After premedication with diazepam and antisialogogues, butorphanol tartrate was used with thiopentone and pancuronium to induce surgical anaesthesia. The induction was smooth in all cases. Nitrous oxide (65 per cent) was used with supplementary small doses of butorphanol tartrate and pancuronium to maintain satisfactory conditions for major abdominal operations in 53 consenting patients. Respiration was invariably controlled with a mechanical respirator. Blood pressure was slightly elevated, pulse rate was stable, and the electrocardiogram was essentially unchanged (lead II) in the majority of patients.

Recovery of adequate respiration was uneventful after reversal of the residual effects of pancuronium. Neostigmine and atropine were the reversal agents. Two patients were given naloxone as well, to reverse excessive drowsiness and respiratory depression apparently due to butorphanol tartrate.

The incidence of other side-effects, such as nausea and vomiting, was not excessive. Amnesia for surgical events was complete in all cases and most of the patients were pleased with the anaesthetic management.

Since butorphanol tartrate provides satisfactory analgesia for major surgery, is available synthetically, has a low propensity to addiction, and has little or no effect on the cardiorespiratory system or on liver and kidney function, we recommend further trial of this compound when a parenteral form of balanced anaesthesia is desired

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From the Department of Anesthesiology, State University of New York, Upstate Medical Center, State University Hospital, Syracuse, New York, 13210, U.S.A.