• The Korean Journal of Pain
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• 제11권2호
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• pp.258-262
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• 1998

Background: In view of the safety and effectiveness of butorphanol as a postoperative analgesic, we designed to compare its activity and side effects with those of ketoprofen, when administered intramuscularly. Methods: Ninety four patients, scheduled for elective total abdominal hysterectomy, received either ketoprofen 100 mg (ketoprofen group) or butorphanol 2 mg (butorphanol group) intramuscularly after surgery. For the first six hours after injection of butorphanol or ketoprofen, the patients were asked to reevaluate the intensity of pain, using numeric rating scale (NRS) and pain score. If the pain score was above 2, supplemental ketoprofen was administered IM. Incidence of side effects were also checked. Results: Butorphanol group showed lower NRS and pain score for the first four hours compared to ketoprofen group, but the incidence of drowsiness was higher in butorphanol group. There were no significant difference in the incidence of other side effects such as nausea and dizziness. In both group, there were neither respiratory depression nor pruritus. Conclusions: Butorphanol gave better relief of postoperative pain compared to ketoprofen. Butorphanol might be a useful drug for postoperative analgesia after hysterectomy with minor side effects.

• The Korean Journal of Pain
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• 제11권2호
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• pp.263-267
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• 1998

Background: This study was designed to know the dose requirement, analgesic efficacy and side effects of butorphanol and nalbuphine when administered with ketorolac by patient controlled analgesia (PCA) after total abdominal hysterectomy. Methods: Forty women who underwent total abdominal hysterectomy received ketorolac (bolus dose 2.4 mg, lockout interval 10 min) with either butorphanol (bolus dose 0.1 mg) or nalbuphine (bolus dose 1 mg) using PCA pump postoperatively. Results: Total amounts of 48 hr consumption were 8.7 mg (butorphanol)and 61.5 mg (nalbuphine). There were no significant differences between two groups in total ketorolac infusion doses, VAS score and side effects. Conclusions: Both butorphanol and nalbuphine were useful for PCA for postoperative pain control. We may suggest that ketorolac 180 mg with butorphanol 9 mg or nalbuphine 70 mg would be useful for 48 hr postoperative pain control.

• The Korean Journal of Pain
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• 제11권1호
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• pp.60-64
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• 1998

Background: We compared butorphanol and fentanyl for opioids use in patient-controlled analgesia(PCA) with ketorolac to determine a suitable drug combination for postoperative pain control. Methods: Sixty patients were equally divided into 2 Groups. Group 1 (n=30) butorphanol 10 mg with ketorolac 180 mg; Group 2 (n=30) fentanyl 1 mg with ketorolac 180 mg, diluting 100 ml solutions intravenously via PCA pump after total abdominal hysterectomy under general anesthesia. Total infusion dosage of PCA drug, VAS pain scores, and side effects of both group were manitored. Results: Total infusion dosages were as follows: (Group 1) butorphanol 8.3 mg with ketorolac 149.7 mg; (Group 2) fentanyl $646.6\;{\mu}g$ with ketorolac 116.2 mg. The two groups showed similar pain scores auld side effects. Conclusions : Both butorphanol and fentanyl were effective for postoperative pain control using PCA pump, but butorphanol was more economical. The putative potency ratio of butorphanol to fantanyl was 12.8 : 1.

• The Korean Journal of Physiology and Pharmacology
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• 제4권4호
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• pp.291-299
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• 2000

Morphine or butorphanol was continuously infused into cerebroventricle (i.c.v.) with the rate of $26\;nmol/{\mu}l/h$ for 3 days, and the withdrawal from opioid was rendered 7 hrs after the stopping of infusion. The expression of physical dependence produced by these opioids was evaluated by measuring the naloxone-precipitated withdrawal signs. The withdrawal signs produced in animals dependent on butorphanol (kappa opioid receptor agonist) were similar to those of morphine (mu opioid receptor agonist). Besides the behavioral modifications, opioid withdrawal affected G protein expression in the central nervous system. The G-protein ${\alpha}-subunit$ has been implicated in opioid tolerance and withdrawal. The effects of continuous infusion of morphine or butorphanol on the modulation of G protein ${\alpha}-subunit$ mRNA were investigated by using in situ hybridization study. In situ hybridization showed that the levels of $G\;{\alpha}s$ and $G\;{\alpha}i$ were changed during opioid withdrawal. Specifically, the level of $G\;{\alpha}s$ mRNA was decreased in the cortex and cerebellar granule layer during the morphine and butorphanol withdrawal. The level of $G\;{\alpha}i$ mRNA was decreased in the dentate gyrus and cerebellar granule layer during the morphine withdrawal. However, the level of $G\;{\alpha}i$ mRNA was significantly elevated during the butorphanol withdrawal. These results suggest that region-specific changes of G protein ${\alpha}-subunit$ mRNA were involved in the withdrawal from morphine and butorphanol.

• 한국임상수의학회지
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• 제29권3호
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• pp.220-225
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• 2012

Medetomidine과 xylazine은 수의 임상에서 많이 이용되고 있는 마취약물이다. Medetomidine-ketamine-butorphanol과 xylazine-ketamine-butorphanol의 개에 미치는 마취효과와 심폐 효과를 비교 연구하였다. Medetomidine-ketamine-butorphanol를 MKB군으로 xylazine-ketamine-butorphanol를 XKB군으로 분류하고 각각 5두의 개를 4주간의 휴약기간을 거쳐 실험하였다. 각각의 군에서 마취효과 점수는 자세와 진통에 대한 반응을 통해 평가하였고, 마취 시간은 XKB군 ($87.4{\pm}18.9$분)이 MKB군 ($62.6{\pm}15.0$분)에 비하여 유의성 있게 높은 시간의 결과를 보였다. 하지만, 기타 심폐 효과에서는 두 군 사이에 통계적으로 유의성 있는 차이를 보이지 않았다. 하지만 MKB군에서는 서맥을 보였으므로, 마취 모니터링 시 주의하여야 한다. 만약 서맥의 위험이 있는 환자라면 MKB 합제는 선택을 안 하는 것이 요구된다. 결론적으로, XKB군에서 더 긴 마취시간과 더 적은 부작용을 보였으며, MKB 합제 약물은 XKB군에 비하여 특별한 장점이 없으므로 XKB 합제가 더욱 유용한 것으로 판단하였다. 하지만 XKB군과 MKB군 모두에서 적절한 체온유지와 산소공급이 필요하다.

• 한국임상수의학회지
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• 제22권1호
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• pp.6-15
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• 2005

본 연구는 개에서 장문합술 후 비침습적인 행동관찰을 통해 통증을 평가하기 위하여 수행되었으며, 또한 이를 토대로 butorphanol의 진통효과에 대해 연구하였다. 본 실험에서 대조군은 마취를 실시하였으나 장문합술은 시행되지 않았다. 진통제 투여군의 5마리 개들에게는 장문합술을 실시하였고 butorphanol을 투여하였다. 진통제 비투여군의 5마리 개들에게는 진통제 투여 없이 장문합술을 실시하였다. 진통제 투여군의 개들은 수술 전 그리고 수술직후 butorphanol(0.4mg/kg, IM)이 투여되었고, 반면에 대조군과 진통제를 투여하지 않은 군에서는 동일한 양의 멸균 생리식염수가 투여되었다. 개의 행동은 마취 후 400분 동안 비디오테이프로 기록되었고, 그 시간에 실험자는 매 80분마다 개와 상호작용을 하였다. 각각의 상호작용에서, 실험자는 관찰된 행동을 바탕으로 멜버른 대학의 통증 측정방법을 이용하여 통증 점수를 기록하였다. 한 사람의 관찰자에 의해 정량화 된 상호작용과 비 상호작용의 행동을 측정하기 위하여 한 개체에 집중하는 연속적 표본 추출 방법이 적용되었다. 발성은 마취 후 400분 동안 녹음하였고 소리 길이, 소리 강도, 소리 pitch와 1-4 포먼트를 분석하였다. 외과수술은 통증측정 점수를 증가시켰다. 실험자와의 상호작용 중에서 수술 후 인사하는 행동이 감소되었다. 진통제를 투여한 수술군과 위약을 투여한 군사이의 차이점은 정량화된 행동측정과 발성을 통하여 구별할 수 있었다. Butorphanol을 투여한 수술군과 위약을 투여한 군 사이에는 유의적인 차이를 관찰할 수 있었다 (p< 0.05).

• The Korean Journal of Pain
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• 제9권2호
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• pp.385-389
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• 1996

Background: Nowadays, epidural morphine is commonly used in postoperative pain control. But epidural morphine may produce some side-effects, e.g. pruritus, nausea, vomiting, urinary retention and respiratory depression. Especially, pruritus is the most common complaint in pain-controlled patients by epidural morphine. So we evaluated whether addition of epidural butorphanol affects the degree of pruritus and pain score in pain controlled patients who by epidural morphine after hysterectomy. Methods: Group 1(N=15) received postoperative epidural 0.1% bupivacaine 100ml plus morphine 10 mg, group 2(N=15) received the mixture of butorphanol 2 mg with same regime as in group 1, group 3(N=15) received the mixture of butorphanol 4 mg with same regime as in group 1. All of the three groups received these solutions by infusion pump, 1 ml/hour, for postoperative 4 days. all groups received additional morphine 1.2 mg in 0.2% bupivacaine 6ml epidurally when the peritoneum was closed under general anesthesia. The severity of pain, pruritus, nausea and vomiting was estimated by 10 cm VAS(visual analogue scale) and somnolence by positive or negative during postoperative 4 days. Results: Severity of pruritus, but not nausea and vomiting was decreased in group 2 and 3 compared with group 1(p<0.05). Pain score was increased in group 3 at postoperative day(POD) 0 and 2 compared with group 1(p<0.05). Incidence of somnolence in group 1, 2 and 3 were $2.7{\pm}0.7,\;5.3{\pm}0.7$ and $10.0{\pm}1.0$ respectively. Conclusion: These results suggest that butorphanol reduce the degree of pruritus, the most common side effect of morphine, but increase the incidence of somnolence.

• The Korean Journal of Pain
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• 제12권2호
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• pp.200-204
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• 1999

Background: Patient-controlled analgesia (PCA) has proven to be safe and effective in children from age 5 years, and older and compares favourably with continuous morphine infusion in the older child. We compared fentanyl and butorphanol for opioid use in PCA with ketorolac to determine a suitable drug combination for post-tonsillectomy pain control. Methods: We studied 60 patients, aged 5~12 yrs, undergoing tonsillectomy with or without adenoidectomy under general anesthesia using $N_2O-O_2$-enflurane. Patients were randomly assigned to receive fentanyl $250\;{\mu}g$ (Group 1: n=30) or butorphanol 5 mg (Group 2: n=30) mixed with ketorolac 90 mg and ondansetron 4 mg diluting 100 ml of 5% D/W solutions intravenously via PCA pump after operation. PCA pump were programmed to deliver a 0.05 ml/kg loading dose, 0.01 ml/kg/hr basal infusion, 0.01 ml/kg on demand bolus, 6 min lockout intervals between doses and 4 bolus hourly limit. Total infusion dosage of PCA drug, VAS pain scores, side effects and satisfaction score of both groups were monitored for 48 hrs. Results: Total infusion dosages were fentanyl $170.6\;{\mu}g$ with ketorolac 61.4 mg (Group 1) and butorphanol 2.8 mg with ketorolac 50.4 mg (Group 2). Total infusion dosage, quality of analgesia, side effects and overall satisfaction didn't differ between two groups. Conclusions: Both fentanyl and butorphanol mixed with ketorolac were effective for post-tonsillectomy pain control using PCA pump in children as young as 5 years old.

• Biomolecules & Therapeutics
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• 제12권4호
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• pp.198-201
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• 2004

This review focuses on finding neurochemical changes in physical dependence on butorphanol, a relatively potent mixed agonist-antagonist opioid analgesic agent that is five times more potent than morphine in antinociceptive effects. The chronic administration of butorphanol induces physical dependence. Withdrawal from such dependence can be reliably precipitated by administration of a narcotic antagonist, e.g., naloxone. Evidence for critical involvement of excitatory aminoacid (glutamate), opioid receptors, and phosphorylation of proteins in these phenomena is summarized.

• Journal of Pharmaceutical Investigation
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• 제33권3호
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• pp.157-162
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• 2003

The feasibility of [P(AA-co-PEGMM)] film as a buccal mucoadhesive patch was previously reported by estimating mucoadhesiveness and release characteristics. To find a rational penetration enhancer of [P(AA-co-PEGMM)] film containing butorphanol tartrate (Bt), penetration of Bt from [P(AA-co-PEGMM)] film which contained various additives was estimated by measuring its flux, Papp and lag tme in in vitro buccal membrane of porcine. EDTA showed almost no increase of Bt permeability, wherease SGC, STDHF and SLS increased the permeability of Bt with the order of SGC > STDHF > SLS. The rational additive concentration of SGC was 4% and its Papp and lag time were $1.93{\times}10^{-4}{\pm}4.21{\times}10^{-6},\;126.60{\pm}21.88min\;(control\;:\;Papp\;0.45{\times}10^{-4};\;lag\;time\;211.01{\pm}16.77\;min)$, respectively.