The effects of fentanyl, oxycodone, and butorphanol on gastrointestinal function in patients undergoing laparoscopic hysterectomy: a prospective, double-blind, randomized controlled trial

• Published in: BMC anesthesiology Vol. 22; no. 1; p. 53
• Main Authors: Guo, Minna, Liu, Shijiang, Gao, Jian, Han, Chuanbao, Yang, Chun, Liu, Cunming
• Format: Journal Article
• Language: English
• Published: England BioMed Central Ltd 24.02.2022; BioMed Central; BMC
• Subjects: Analgesia; Analgesics, Opioid; Analysis; Butorphanol - adverse effects; Cisatracurium; Clinical trials; Dizziness - chemically induced; Dizziness - complications; Double-Blind Method; Female; Fentanyl; Gastrointestinal system; Health aspects; Humans; Hysterectomy; Hysterectomy - adverse effects; Laparoscopic surgery; Laparoscopy; Laparoscopy - adverse effects; Medical care, Cost of; Opioid receptor; Oxycodone; Pain, Postoperative - drug therapy; Pain, Postoperative - etiology; Patient satisfaction; Postoperative gastrointestinal tract dysfunction; Prospective Studies; Remifentanil; Sleepiness; Sufentanil; Women; Postoperative gastrointestinal tract dysfunction; Analgesia; Opioid receptor
• ISSN: 1471-2253; 1471-2253
• DOI: 10.1186/s12871-022-01594-9

Perioperative opioid use is associated with postoperative bowel dysfunction, which causes longer hospital stay and higher healthcare costs. This study aimed to investigate the effect of the equivalent doses of fentanyl, oxycodone, and butorphanol on bowel function in patients undergoing laparoscopic hysterectomy. In this randomized controlled trial, 135 patients undergoing laparoscopic hysterectomy received postoperative intravenous patient-controlled analgesia (IV-PCA) with fentanyl 8.3 μg/kg, butorphanol 0.16 mg/kg, and oxycodone 0.5 mg/kg (1: 20: 60), respectively. The primary outcome measure was the recovery of bowel function. We also evaluated and recorded the following nine indicators: pain score, sedation level, leukocyte count, percentage of neutrophils, plasma potassium levels, time to first ambulation, postoperative side effects, patients' satisfaction, and postoperative hospital length of stay. The mean time to flatus was significantly prolonged in Group B (45.2 ± 11.6 h) compared with Group F (33.1 ± 11.2 h, P < 0.001) and Group O (36.2 ± 10.9 h, P = 0.001). The incidence of somnolence and dizziness prove higher in Group B (P < 0.001). No statistical difference was observed in the mean time to tolerate oral diet, time to defecation, analgesic outcome, satisfaction score, time to first ambulation, and postoperative hospital length of stay. Compared with fentanyl and oxycodone, butorphanol prolonged the recovery of bowel function with more severe somnolence and dizziness, suggesting that butorphanol is not well suitable for IV-PCA in patients undergoing laparoscopic hysterectomy. ClinicalTrials.gov- NCT04295109 . Date of registration: March, 2020.