Butorphanol versus Propofol in Patients Undergoing Noninvasive Ventilation: A Prospective Observational Study

• Main Authors: Wang X, Meng J
• Format: Article
• Language: English
• Published: Dove Medical Press 2021-03-01
• Series: International Journal of General Medicine
• Subjects: butorphanol; acute respiratory failure; noninvasive ventilation
• Online Access: https://www.dovepress.com/butorphanol-versus-propofol-in-patients-undergoing-noninvasive-ventila-peer-reviewed-article-IJGM

Xiaohong Wang,1 Jianbiao Meng2 1Intensive Care Unit, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang Province, 310003, People’s Republic of China; 2Intensive Care Unit, Tongde Hospital of Zhejiang Province, Hangzhou, Zhejiang Province, 310012, People’s Republic of ChinaCorrespondence: Jianbiao MengIntensive Care Unit, Tongde Hospital of Zhejiang Province, #234 Gucui Road, Hangzhou, Zhejiang Province, 310012, People’s Republic of ChinaEmail [e-mail]: The present study aimed to explore sedation management in agitated patients who suffered from acute respiratory failure (ARF) and were treated with noninvasive ventilation (NIV).Patients and Methods: We divided 118 patients undergoing NIV treatment with butorphanol or propofol into two groups: group B (n = 57, butorphanol was initiated at the rate of 0.12 μg/kg/min as a continuous intravenous infusion and then titrated by 0.06 μg/kg/min every half an hour, group P (n = 61, propofol was initiated at the rate of 5 μg/kg/min as a continuous intravenous infusion and then titrated by 1.5 μg/kg/min every half an hour). Score of Sedation Agitation Scale (SAS) in the two groups was maintained between 3 and 4. Medications including sedative, analgesic, and antipsychotic, NIV intolerance score, SAS score, visual analog scale (VAS), medication use and adverse events were recorded repeatedly.Results: Patients receiving butorphanol required significantly less total amount of fentanyl than patients receiving propofol during NIV to maintain the target VAS [0 (0– 0) μg vs 150 (50– 200) μg, P< 0.005]. Hemodynamic stability during NIV showed it was better kept in patients treated with butorphanol.Conclusion: Butorphanol not only decreased the requirements of fentanyl but also enhanced hemodynamic stability in agitated patients suffering from ARF receiving NIV.Trial Registration: Registered at http://www.chictr.org.cn/ (ChiCTR1800015534).Keywords: butorphanol, acute respiratory failure, noninvasive ventilation