Double-Blind Comparison of Butorphanol and Meperidine in the Treatment of Post-Surgical Pain

Abstract

The efficacy and safety of butorphanol tartrate were compared in a double-blind manner to meperidine hydrochloride in 299 patients with moderate to severe post-operative pain. When analgesia was requested, patients were medicated with butorphanol (1.0 or 2.0 mg) or meperidine (40 or 80 mg) administered intramuscularly according to a pre-determined computer-generated random schedule. Evaluation of pain relief data showed no significant differences between butorphanol and meperidine at the low doses and at the high dose levels. Onset of analgesia, peak effect (thirty to sixty minutes) and duration of action (approximately four hours) were comparable. Thus, the data support a 40:1 butorphanol to meperidine potency ratio. There was little difference between the drugs with respect to adverse reactions, effects on vital signs, and variations in laboratory values. The incidence of nausea and vomiting was more common in the meperidine-treated patients. Respiratory depression occurred in three patients who received meperidine and in one to whom butorphanol was administered. One meperidine-treated patient experienced hallucinations, a phenomenon not observed following butorphanol. On the basis of these data, butorphanol appears to be a safe, well tolerated and highly effective analgesic for the treatment of moderate to severe postoperative pain.