Study Objective: To examine the effects of additional droperidol or butorph
anol to epidural fentanyl infusion on postsurgical analgesia.
Design: Prospective, randomized, single blinded clinical study.
Setting: University-affiliated medical center.
Patients: 60 ASA physical status I and II patients undergoing anorectal sur
gery by one surgeon.
Interventions: Patients were randomly allocated to the following groups acc
ording to the medication that was continuously administered into the epidur
al space: 1) Group C (n = 20) received 0.4 mg fentanyl in 40 ml of 0.125% b
upivacaine; 2) Group D (n = 20) received 2.5 mg droperidol and 0.4 mg fenta
nyl in 40 ml of 0.125% bupivacaine; and 3) Group B (n = 20) received 2 mg b
utorphanol and 0.4 mg fentanyl in 40 ml of 0.125% bupivacaine over 24 hours
Measurements and Main Result: Postsurgical analgesia and the incidence of f
entanyl-related complications, such as nausea/vomiting, somnolence, pruritu
s, and respiratory depression, were assessed for 24 hours postoperatively.
At 16 and 24 hours after surgery, 75% of patients in Group D reported no pa
in versus 35% in Group C (p < 0.05). In addition, the overall visual analog
ue scale examined at 24 hours was significantly lower in Group D than that
in Group C (22 +/- 17 mm vs. 44 +/- 22 mm, respectively; p < 0.05). Simulta
neously, the incidence of postoperative nausea/vomiting was lower in Group
D compared with Group C (20% vs. 60%; p < 0.05). On the other hand butorpha
nol did not modify the analgesic effects or complications of epidural fenta
Conclusion: In this study population, additional droperidol, not butorphano
l, improved postsurgical analgesia accompanied by less incidence of nausea/
vomiting during epidural fentanyl administration. (C) 2000 by Elsevier Scie