Butorphanol and promethazine as pre-anaesthetic medication

Chemical restraint and analgesia in the horse

Chemical restraint in the standing horse is used for a variety of procedures in veterinary medicine. The choice of agent depends on the physical status, temperament, and size of the patient; the procedure to be performed; and safety for the patient, veterinarian, and owner. The combination of certain agents may provide more desirable restraint and analgesia than does the use of individual agents. The use of analgesics in the horse is not without side effects, some of which may be detrimental to the patient's condition. Analgesics should be chosen with these untoward effects in mind. Draft breeds possess differences that may provide a challenge to the practitioner. One such difference is their clinically apparent increased sensitivity to tranquilizers and sedative-hypnotics; consequently, reduced dose regimens for chemical restraint should be employed initially.

Thiopental-sparing properties of butorphanol/diazepam for induction of anesthesia in ambulatory gynecologic surgery

Butorphanol/diazepam was compared with thiopental for induction of anesthesia, and the thiopental-sparing effects of butorphanol/diazepam determined. One hundred women, American Society of Anesthesiology physical status class I, undergoing ambulatory, elective termination of pregnancy were randomized to receive either butorphanol 2 mg plus diazepam 10 mg, or thiopental, until loss of the lid reflex occurred. The butorphanol/diazepam group received supplemental thiopental as necessary to attain adequate induction of anesthesia. The combination of butorphanol and diazepam significantly reduced the thiopental dose required to produce loss of the lid reflex, from 4.2 +/- 0.8 to 0.8 +/- 0.6 mg/kg (p less than 0.005), with 22 percent of the patients not requiring supplemental thiopental. The intraoperative course and anesthetic requirements were similar between the two groups. Lower recovery room rating scale values upon arrival at the recovery room were attributed to significantly higher weight-normalized doses of butorphanol (p = 0.004) and diazepam (p = 0.005). The duration of the recovery room stay was 68.8 +/- 24.9 min for the control group, and 80.8 +/- 29.0 min for the butorphanol/diazepam-treated patients (p = 0.026). There were no clinically significant differences in anesthesia or postanesthesia recovery. The combination of butorphanol and diazepam has a significant thiopental-sparing effect, and is a useful induction technique for short, ambulatory surgical procedures.

An effective method of inducing analgesia and anesthesia for dermatoplastic surgery in an office

Butorphanol tartrate (Stadol [Bristol]) and diazepam (Valium [Roche]) given intravenously in combination, in proper doses, and properly monitored are effective and safe to induce analgesia and calmness preliminary to extensive infiltration of local anesthetics that are otherwise painful and distressin. They are particularly good for moderately long and prolonged dermatoplastic procedures, and all the better because their analgesic and calmative effects last well into the postoperative period.