Effectiveness of stadol NS (Butorphanol tartrate) with ibuprofen in the treatment of pain after laser-assisted. uvulopalatopharyngoplasty

Purpose: Laser-assisted uvulopalatopharyngoplasty (LA-UPPP) is a recently d eveloped technique for treating snoring and mild sleep apnea. This treatmen t is associated with severe postoperative pain. This study evaluated the ef fectiveness and safety of transnasal administration of butorphanol tartrate (Stadol NS; Bristol-Myers Squibb. New York, NY) as a primary means of cont rolling pain after this surgical procedure. Patients and Methods: Twenty patients (14 men and 6 women, mean age, 43 yea rs) were enrolled and treated with LA-UPPP and radiofrequency turbinate pro cedures (coblation) for severe snoring and chronic nasal congestion in an o pen label study. The same surgeon performed all procedures. Patients were a dvised to take 2 tablets of ibuprofen (200 mg each) and use a single 1 mg s pray of Stadol NS in 1 nostril for the initial dose. If adequate pain relie f was not achieved in 1 to 1.5 hours, an additional 1 mg dose of Stadol NS was recommended. Thereafter, they could repeat the ibuprofen and Stadol NS every 3 to 4 hours, as needed. Comprehensive preoperative and postoperative evaluations were made using a visual analog scale of 0 to 10, with 0 equal to no pain and 10 being the most severe. Patients were followed-up for 14 days. Results: All 20 patients had LA-UPPP and nasal turbinate radiofrequency cob lation, and all 20 were eligible for both efficacy and safety analysis. Pai n was reduced from a mean of 6.6 to a mean of 3.3 (50%) after an average of 48 minutes after the initial dose. Conclusion: Stadol NS appears to be an effective treatment for moderate-to- severe pain after LA-UPPP. Lf patients hare difficulty swallowing, which is the case with most throat surgeries performed by oral and maxillofacial su rgeons and otolaryngologists, the transnasal route of administration reduce s the number of oral medications taken by the patient. (C) 2000 American As sociation of Oral and Maxillofacial Surgeons.