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Xu Q, Li QG, Fan GR, Liu QH, Mi FL, Liu B. Protective effects of fentanyl preconditioning on cardiomyocyte apoptosis induced by ischemia-reperfusion in rats. ACTA ACUST UNITED AC 2017; 50:e5286. [PMID: 28225864 PMCID: PMC5343559 DOI: 10.1590/1414-431x20165286] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2016] [Accepted: 10/29/2016] [Indexed: 01/05/2023]
Abstract
We aimed to study the effect of fentanyl (Fen) preconditioning on cardiomyocyte
apoptosis induced by ischemia-reperfusion (I/R) in rats. A total of 120 Sprague
Dawley male rats (age: 3 months) were randomly divided into: sham operation group (S
group), I/R group, normal saline I/R group (NS group), and fentanyl low, middle, and
high dose groups (Fen1: 2 μg/kg; Fen2: 4 μg/kg; Fen3: 6 μg/kg). Heart rate (HR), mean
arterial pressure (MAP), left ventricular developed pressure (LVDP), ±dp/dtmax,
malondialdehyde (MDA), superoxide dismutase (SOD) activity, creatine phosphokinase-MB
(CK-MB), and cardiac troponin-I (cTnI) were measured. Myocardial ischemic (MI) area,
total apoptotic myocardial cells, and protein and mRNA expressions of B-cell lymphoma
2 (Bcl-2) and Bax were detected. HR and MAP were higher, while LVDP and ±dp/dtmax
were close to the base value in the Fen groups compared to those in the I/R group.
Decreased MDA concentration and CK-MB value and increased SOD activity were found in
the Fen groups compared to the I/R group, while cTnI concentration was significantly
lower in the Fen1 and Fen2 groups (all P<0.05). Myocardial damage
was less in the Fen groups compared to the I/R group and the MI areas and apoptotic
indexes were significantly lower in the Fen1 and Fen2 groups (all
P<0.05). Furthermore, significantly increased protein and mRNA
expressions of Bcl-2, and decreased protein and mRNA expressions of Bax were found in
the Fen groups compared to the I/R group (all P<0.05). Fentanyl preconditioning
may suppress cardiomyocyte apoptosis induced by I/R in rats by regulating Bcl-2 and
Bax.
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Affiliation(s)
- Q Xu
- Department of Anesthesiology, Linyi People's Hospital, Linyi, Shandong, China
| | - Q-G Li
- Department of Anesthesiology, Linyi Cancer Hospital, Linyi, Shandong, China
| | - G-R Fan
- Operation Room, Linyi People's Hospital, Linyi, Shandong, China
| | - Q-H Liu
- Department of Anesthesiology, Linyi People's Hospital, Linyi, Shandong, China
| | - F-L Mi
- Department of Anesthesiology, Linyi People's Hospital, Linyi, Shandong, China
| | - B Liu
- Department of Anesthesiology, Linyi People's Hospital, Linyi, Shandong, China
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Babu S, Gupta BK, Gautam GK. A Comparative Study for Post Operative Analgesia in the Emergency Laparotomies: Thoracic Epidural Ropivacaine with Nalbuphine and Ropivacaine with Butorphanol. Anesth Essays Res 2017; 11:155-159. [PMID: 28298776 PMCID: PMC5341686 DOI: 10.4103/0259-1162.186593] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
Abstract
BACKGROUND Adequate postoperative pain therapy for emergency abdominal surgeries is important far beyond the perioperative period because sensitization to painful stimuli can cause postoperative morbidity. A prospective, double-blind, randomized study was carried out to compare the quality of postoperative analgesia and side-effect profile between epidurally administered butorphanol and nalbuphine as an adjuvant to 0.2% ropivacaine. MATERIALS AND METHODS A total of eighty patients, 43 men and 37 women between the age of 18 and 65 years of American Society of Anesthesiologists (ASA) Class I E and II E, who underwent intestinal perforation repair surgery were randomly allocated into two groups ropivacaine with butorphanol (RB) and ropivacaine with nalbuphine (RN), comprising of 40 patients each. Group RB received 0.2% ropivacaine containing 2 mg butorphanol while Group RN received 0.2% ropivacaine containing 10 mg nalbuphine through thoracic epidural catheter. Quality of analgesia, cardiorespiratory parameters, side-effects, and the need of rescue intravenous analgesia were observed. RESULTS The demographic profile and ASA Class were comparable between the groups. RN group had good quality of analgesia and stable cardiorespiratory parameters for the initial 6 h of postoperative period, after which they were comparable in both groups. Furthermore, the need of rescue analgesia was higher (20%) in the RB group during the first 6 h. The side-effect profile was comparable with a little higher incidence of nausea in both groups. CONCLUSION Thoracic epidurally administered ropivacaine with nalbuphine is more effective than ropivacaine with butorphanol for immediate postoperative pain relief in patients undergoing emergency exploratory laparotomy.
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Affiliation(s)
- Saravana Babu
- Department of Anaesthesiology and Critical Care Medicine, G.S.V.M. Medical College, Kanpur, Uttar Pradesh, India
| | - Bikram Kumar Gupta
- Department of Anaesthesiology and Critical Care Medicine, G.S.V.M. Medical College, Kanpur, Uttar Pradesh, India
| | - Gyanendra Kumar Gautam
- Department of Anaesthesiology and Critical Care Medicine, G.S.V.M. Medical College, Kanpur, Uttar Pradesh, India
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Lin L, Liu S, Chen Z, Lin S. Effect of ketamine combined with butorphanol on emergence agitation of postoperative patients with gastric cancer. Ther Clin Risk Manag 2016; 12:713-7. [PMID: 27217761 PMCID: PMC4863591 DOI: 10.2147/tcrm.s103060] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Background This study aimed to investigate the effect of ketamine combined with butorphanol on emergence agitation (EA) in postoperative gastric cancer patients. Materials and methods A total of 150 patients with gastric cancer were included and divided into group B (1 mg butorphanol before anesthesia induction, n=50), group K (1 mg/kg ketamine, n=50), and group C (1 mg butorphanol combined with 1 mg/kg ketamine, n=50). Mean arterial pressure (MAP) and heart rate (HR) at the end of operation, just before extubation (T0) and at 0 minute (T1), 5 minutes (T2), and 30 minutes (T3) after extubation were compared. Statistical analysis of recovery time, extubation time, time in postanesthesia care unit, and EA incidence and adverse reactions were performed. Results There were no differences among groups with respect to MAP and HR at T0 and T1 (P>0.05). Compared with patients in group C, significant reduction of MAP and HR were observed in groups K and B at T2 and T3 (P<0.05), while no differences were found between group K and group B (P>0.05). Recovery time, extubation time, time in postanesthesia care unit, and incidence of EA in group C were significantly less than those in groups K and B (P<0.05), but no differences were observed between group K and group B (P>0.05). Total incidence of adverse reactions were significantly increased in group K compared to those in groups C and B (P<0.05). Conclusion Injection of ketamine combined with butorphanol before anesthesia induction was more effective than injection of ketamine or butorphanol separately in the prevention of EA.
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Affiliation(s)
- Liang Lin
- Department of Anesthesiology, The First Affiliated Hospital of Xiamen University, Xiamen, Fujian, People's Republic of China
| | - Shuncui Liu
- Department of Anesthesiology, The First Affiliated Hospital of Xiamen University, Xiamen, Fujian, People's Republic of China
| | - Zhenyi Chen
- Department of Anesthesiology, The First Affiliated Hospital of Xiamen University, Xiamen, Fujian, People's Republic of China
| | - Shaoli Lin
- Department of Anesthesiology, The First Affiliated Hospital of Xiamen University, Xiamen, Fujian, People's Republic of China
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Jose DE, Ganapathi P, Anish Sharma NG, Shankaranarayana P, Aiyappa DS, Nazim M. Postoperative pain relief with epidural buprenorphine versus epidural butorphanol in laparoscopic hysterectomies: A comparative study. Anesth Essays Res 2016; 10:82-7. [PMID: 26957696 PMCID: PMC4767084 DOI: 10.4103/0259-1162.173612] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
Background: The purpose of this study was to compare the safety and efficacy of postoperative analgesia with epidural buprenorphine and butorphanol tartrate. Methods: Sixty patients who were scheduled for elective laparoscopic hysterectomies were randomly enrolled in the study. At the end of the surgery, in study Group A 1 ml (0.3 mg) of buprenorphine and in Group B 1 ml (1 mg) of butorphanol tartrate both diluted to 10 ml with normal saline was injected through the epidural catheter. Visual analog pain scales (VAPSs) were assessed every hour till the 6th h, then 2nd hourly till the 12th h. To assess sedation, Ramsay sedation score was used. The total duration of postoperative analgesia was taken as the period from the time of giving epidural drug until the patients first complain of pain and the VAPS is more than 6. Patients were observed for any side effects such as respiratory depression, nausea, vomiting, hypotension, bradycardia, pruritus, and headache. Results: Buprenorphine had a longer duration of analgesia when compared to butorphanol tartrate (586.17 ± 73.64 vs. 342.53 ± 47.42 [P < 0.001]). Nausea, vomiting (13% vs. 10%), and headache (20% vs. 13%) were more in buprenorphine group; however, sedation score and pruritus (3% vs. 6%) were found to be more with butorphanol. Conclusion: Epidural buprenorphine significantly reduced pain and increased the quality of analgesia with a longer duration of action and was a better alternative to butorphanol for postoperative pain relief.
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Affiliation(s)
- Dona Elsa Jose
- Department of Anaesthesiology, KVG Medical College, Sullia, Dakshina Kannada, Karnataka, India
| | - P Ganapathi
- Department of Anaesthesiology, KVG Medical College, Sullia, Dakshina Kannada, Karnataka, India
| | - N G Anish Sharma
- Department of Anaesthesiology, KVG Medical College, Sullia, Dakshina Kannada, Karnataka, India
| | - P Shankaranarayana
- Department of Anaesthesiology, KVG Medical College, Sullia, Dakshina Kannada, Karnataka, India
| | - D S Aiyappa
- Department of Anaesthesiology, KVG Medical College, Sullia, Dakshina Kannada, Karnataka, India
| | - Mohammed Nazim
- Department of Anaesthesiology, KVG Medical College, Sullia, Dakshina Kannada, Karnataka, India
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Analgesic effect and pharmacological mechanism of fentanyl and butorphanol in a rat model of incisional pain. J Clin Anesth 2016; 28:67-73. [DOI: 10.1016/j.jclinane.2015.08.010] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2014] [Revised: 04/21/2015] [Accepted: 08/13/2015] [Indexed: 11/23/2022]
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Swathi N, Ashwini N, Shukla MI. Comparative study of epidural bupivacaine with butorphanol and bupivacaine with tramadol for postoperative pain relief in abdominal surgeries. Anesth Essays Res 2016; 10:462-467. [PMID: 27746533 PMCID: PMC5062192 DOI: 10.4103/0259-1162.177522] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Introduction: To compare the efficacy of combination of epidural local anesthetic with tramadol and butorphanol in major abdominal surgeries. Aims: To evaluate duration of analgesia, analgesic efficacy, and safety profile of two groups of drugs-epidural butorphanol with bupivacaine and epidural tramadol with bupivacaine. Materials and Methods: A prospective, randomized controlled, double-blinded study was undertaken in 50 patients scheduled for major abdominal surgeries. Group B received epidural butorphanol 2 mg + bupivacaine 0.125% first dose and subsequent doses, butorphanol 1 mg + bupivacaine 0.125% (total volume 10 ml). Group T received epidural tramadol 2 mg/kg + bupivacaine 0.125% first dose and subsequent doses, tramadol 1 mg/kg + bupivacaine 0.125% (total volume 10 ml). Observed parameters were the quality of analgesia, sedation, and hemodynamic parameters in the intra and post-operative period. Time for request of rescue analgesia was noted in all the patients. Continuous data are analyzed by Student's t-test using IBM SPSS software version 20. P ≤0.05 was considered to be statistically significant. P ≤ 0.001 was considered to be statistically highly significant. Results: Visual analog scale better with butorphanol group than tramadol (0.12 ± 0.332 and 0.84 ± 0.746 for Group B and Group T) at 30 min after first dose. Onset of action (8.44 ± 1.158 min in Group B and 12.80 ± 1.354 min in Group T) faster with butorphanol but duration of analgesia longer with tramadol (5.92 ± 0.76 h in Group B vs. 7.68 ± 0.76 h in Group T). Sedation was seen in patients with butorphanol group. Nausea and vomiting more frequent with tramadol group. Conclusions: Epidural tramadol with antiemetic is better than butorphanol for its longer duration in ambulatory surgery, elderly patients, obese patients, and suitable high-risk patients.
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Affiliation(s)
- N Swathi
- Department of Anaesthesia, Bangalore Medical College and Research Institute, Bengaluru, Karnataka, India
| | - N Ashwini
- Department of Anaesthesia, JSS Medical College and Hospital, Mysore, Karnataka, India
| | - Mukesh I Shukla
- Department of Anaesthesia, B.J. Medical College, Ahmedabad, Gujarat, India
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