Background: The present study aimed to explore sedation management in agitated patients who suffered from acute respiratory failure (ARF) and were treated with noninvasive ventilation (NIV).
Patients and Methods: We divided 118 patients undergoing NIV treatment with butorphanol or propofol into two groups: group B (n = 57, butorphanol was initiated at the rate of 0.12 μg/kg/min as a continuous intravenous infusion and then titrated by 0.06 μg/kg/min every half an hour, group P (n = 61, propofol was initiated at the rate of 5 μg/kg/min as a continuous intravenous infusion and then titrated by 1.5 μg/kg/min every half an hour). Score of Sedation Agitation Scale (SAS) in the two groups was maintained between 3 and 4. Medications including sedative, analgesic, and antipsychotic, NIV intolerance score, SAS score, visual analog scale (VAS), medication use and adverse events were recorded repeatedly.
Results: Patients receiving butorphanol required significantly less total amount of fentanyl than patients receiving propofol during NIV to maintain the target VAS [0 (0– 0) μg vs 150 (50– 200) μg, P < 0.005]. Hemodynamic stability during NIV showed it was better kept in patients treated with butorphanol.
Conclusion: Butorphanol not only decreased the requirements of fentanyl but also enhanced hemodynamic stability in agitated patients suffering from ARF receiving NIV.
Trial Registration: Registered at http://www.chictr.org.cn/ (ChiCTR1800015534).
Keywords: butorphanol, acute respiratory failure, noninvasive ventilation