Comparative analysis of safety and effectiveness of butorphanol and pethidine in the prevention of shivering during appendectomy

Feng Xia; Zhang Guangming

doi:10.3760/cma.j.issn.1673-4777.2016.12.017

Abstract：Objective To investigate the safety and effectiveness of butorphanol and pethidine in the prevention of shivering during appendectomy.Methods A total of 120 patients undergoing elective appendectomy with subarachnoid-epidural anesthesia(ASA grade Ⅰ or Ⅱ) from October 2014 to October 2015 in Tong Ren Hospital,Shanghai Jiao Tong University School of Medicine were randomly divided into butorphanol group,pethidine group and control group,each group of 40 cases.After anesthesia procedure,butorphanol group,pethidine group and control group were treated with butorphanol 1 mg(diluted to 5 ml with 0.9％ sodium chloride solution),pethidine 15 mg(diluted to 5 ml with 0.9％ sodium chloride solution) and 0.9％ sodium chloride solution 5 ml,respectively,with intravenous injection in 1 min.Mean arterial pressure(MAP),pulse oxygen saturation(SpO2)and heart rate were recorded before drug administration and at 5,15,30 min after drug administration.Occurrences of shivering and adveme reactions were observed.Results MAP and heart rate in pethidine group at 5 min after treatment were significantly higher than those before treatment and those in control group and butorphanol group at the same time point [(113 ± 13) mmHg vs (89 ± 12),(89 ± 12),(90 ± 13) mmHg;(106 ±9) times/min vs (77 ± 6),(76 ± 5),(77 ± 5) times/min] (P ＜ 0.05);differences of MAP,SpO2 and heart rate between butorphanol group and control group were not significant (P ＞ 0.05).Incidences of shivering in butorphanol group and pethidine group at 5,10 min after treatment were significantly lower than those in control group[5.0％ (2/40),12.5％ (5/40) vs 40.0％ (16/40);0.0％ (0/40),0.0％ (0/40) vs 22.5％ (9/40)](P ＜ 0.05);the difference of shivering incidence between butorphanol group and control group was not significant (P ＞ 0.05).The incidence of nausea and vomiting in pethidine group was significantly higher than those in butorphanol group and control group [35.0％ (14/40) vs 0.0％ (0/40),5.0％ (2/40)] (P ＜ 0.05);the incidence of sleepiness in butorphanol group was significantly higher than those in pethidine group and control group[82.5％ (33/40) vs 22.5％ (9/40),0.0％ (0/40)] (P ＜0.05).Conclusion Both butorphanol and pethidine can effectively prevent the occurrence of shivering during appendectomy;butorphanol is associated with a lower incidence of adverse reactions and has no significant effect on the hemodynamics in patients.