A comparative study of intravenous and transnasal butorphanol as an analgesic in laparoscopic cholecystectomy”

Laparoscopic cholecystectomy has revolutionized gallbladder surgeries and it has now become the “gold standard” of cholelithiasis. It offers many benefits than conventionalcholecystectomy, and has been promoted, as a“gentle surgery”. Laparoscopic cholecystectomy combines the benefits of completely removing the gall bladder with the advantages of shorter hospital stays, more rapid return of normal activities, less pain associated with small limited incision and less postoperative ileus compared with the open laparotomy technique. However, this procedure is not risk free.In fact it produces significant hemodynamic changes. Pain is as old as human being and is becoming more and more troublesome to mankind with greater incidence of medical surgeries. Breaking the pain cycle at an early stage may prevent central sensitization and, consequently, chronic pain. A second objective is to improve surgical outcome with the goals of enabling early ambulation and recovery of gastrointestinal function which in turn reduce cardiopulmonary morbidity, psychological stress, anxiety and insomnia. Butorphanol is a synthetic opioid derivative possessing agonist-antagonist activity at opioid µ2-receptors and additional agonist activity at opioid κ-receptors. preventing a poor learned response to future pain episodes.