Safety and Efficacy of Butorphanol as an Analgesic for Patients on Mechanical Ventilation after Cardiac Surgery: An Exploratory Prospective Observational Study

Abstract

Purpose: This study assessed the safety and analgesic efficacy of butorphanol in patients receiving mechanical ventilation after cardiac surgery. Methods:  This was a prospective study. A consecutive cohort of patients from our medical center who underwent cardiac surgery followed by mechanical ventilation between January 2021 and April 2022 were divided into two groups and received either butorphanol or morphine for analgesia, and all patients also received propofol for sedation. Statistical analysis was performed using the t-test or chi-square test, and the pain levels of the two groups were compared based on the Critical-Care Pain Observation Tool (CPOT), as well as sedation based on the Richmond Agitation-Sedation Scale (RASS), and incidences of adverse events. Results: The two groups, each of which contained 70 patients, reported similar analgesic efficacy; the CPOT score was almost 0 and the RASS score was between 0 and –3. The butorphanol group experienced significantly lower rates of nausea, respiratory depression, and drowsiness. However, the two groups experienced similar rates of vomiting, pruritus, drowsiness, constipation, and delirium, durations of mechanical ventilation, use of sedative drugs, and lengths of stay in the intensive care unit. Conclusions: For patients on mechanical ventilation after cardiac surgery, butorphanol can provide analgesic effects similar to those of morphine with a potentially lower risk of certain adverse events.