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Anesth Analg 1984; 63:139-142
© 1984 International Anesthesia Research Society
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Effects of Butorphanol, Nalbuphine, and Fentanyl on Intrabiliary Tract Dynamics

Richard L. McCammon, MD, Robert K. Stoelting, MD, and James A. Madura, MD

Departments of Anesthesia and Surgery, Indiana University School of Medicine, Indianapolis, Indiana.

Abstract

The effects of equianalgesk doses of fentanyl citrate (100 µg; n = 20), butorphanol tartrate (2 mg; n = 20), and nalbuphine hydrochloride (10 mg; n=16) on biliary tract dynamics were examined in patients anesthetized with enflurane-nitrous oxide. After removal of the gall bladder, the common bile duct or cystic duct remnant was cannulated with an 18-gauge catheter. Using a modified Caroli apparatus, control measurements of flow through the common bile duct into the duodenum over 60 sec and resting intrabiliary tract pressure were obtained. Patients then were given one of the drugs intravenously and measurements were repeated 5 rain later. Flow rates decreased 35%, 21%, and 13% after fentanyl, butorphanol, and nalbuphine, respectively. Similarly, resting intrabiliary tract pressures increased by 23%, 12%, and 6%, respectively. All changes were statistically significant (P < 0.05) except for the increase in intrabiliary tract pressure after nalbuphine. Likewise, the incidence of decreases in flow rate or increases in intrabiliary tract pressure more than 20% was greater after fentanyl than after either butorphanol or nalbuphine. Agonist-antagonist analgesics may be advantageous in patients with known or suspected biliary tract disease.

Key Words: ANALGESICS—butorphanol, fentanyl, nalbuphine • LIVER—biliary tract




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Lippincott, Williams & Wilkins Anesthesia & Analgesia® is published for the International Anesthesia Research Society® by Lippincott Williams & Wilkins and Stanford University Libraries' HighWire Press®. Copyright 1984 by the International Anesthesia Research Society. Online ISSN: 1526-7598   Print ISSN: 0003-2999 HighWire Press
Copyright © 1984 by the International Anesthesia Research Society.