Double-blind comparison of butorphanol and meperidine in the treatment of post-surgical pain.
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Biomedical subjects
Publications and source records attributed to H L Zauder.
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Butorphanol tartrate, a synthetic morphinan which has analgesic agonist and antagonist properties, was compared with meperidine for balanced anaesthesia. The two agents were found to be comparable in efficacy, maintenance of cardiovascular stability, and incidence of side-effects. Butorphanol has the advantage of being non-narcotic and having a lower propensity for addiction. Because of its antagonist properties, there appears to be a limit to its depressant effects on respiration.
Over a 7-yr period from January 1967 to January 1974, 141 patients underwent thyroid surgery for various pathology at the Bexar County Hospital - University of Texas Medical School at San Antonio. Of these, 113 patients underwent subtotal thyroidectomy for benign diseases, including 28 of thyrotoxic patients who underwent subtotal thyroidectomy as definitive treatment. In this group of patients special interest and emphasis was placed in the preoperative and intraoperative management of the difficult and complicated hyperthyroid patient. Preoperative treatment was accomplished by the utilization of multiple drug combinations - including antithyroid drugs, adrenergic blocking agents, and iodine - which resulted in significant decrease in preparation time for surgery. Furthermore, this short intensive preoperative management of complicated hyperthyroid patients allowed satisfactory correction of their problems with little or no morbidity which otherwise would have been extremely difficult if not impossible to resolve. At operation, 28 patients were diagnosed to have malignant disease; 23 underwent total thyroidectomy and the other 5 had subtotal thyroidectomy. In addition to total or subtotal thyroidectomy, 23 patients had either classical or modified radical neck dissection including 9 patients who had bilateral neck dissection. The various surgical techniques utilized, the rationale for rapid preoperative preparation of complicated hyperthyroid patients, morbidity, and long-term follow-up are discussed.
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The effect of enflurane on uterine contractility was studied in sexually mature rabbits in which intrauterine balloon catheters had been implanted. Three animal groups were studied: untreated; treated with estrogen-progesterone; and 27 to 28 days pregnant. The effects of 1.5 percent or 3.0 percent enflurane were quantitated by measuring contraction frequency and amplitude during an anesthetically steady state. The effects of prior anesthesia with 1.5 percent enflurane on uterine responses to 1.5 IU oxytocin IV were also evaluated. Neither 1.5 percent of 3.0 percent enflurane altered contraction amplitude or frequency in the 3 groups of rabbits. However, the amplitude of the contractile response to oxytocin 30 minutes following enfluane was significantly depressed. The results indicate that, while the intact rabbit uterus under different hormonal influences is not depressed by 1.5 or 3.0 percent enflurane, its response to oxytocin following enflurane is decreased.
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