Stadol is Inferior in Every Study

Butorphanol (Stadol) is a highly addictive older narcotic pushed by Bristol-Myers-Squibb.  They have funded numerous studies comparing it to other narcotics, but I could find only one study in humans comparing it to a non-narcotic.  That independent study found Stadol is inferior for children for relief of pain during ear surgery.  Also, in five out of five animal studies with cats, dogs, and horses, butorphanol was definitely inferior.  Once again, the U.S. FDA and a narcotic manufacturer treat American citizens worse than dogs.  With a track record of 0 for 6, Stadol is a loser.  This highly addictive narcotic should be immediately withdrawn from the market.  The harm it causes to society is vastly in excess of any benefit.

Dog Surgery: Non-Narcotic NSAIDs Meloxicam and Ketoprofen Both Superior to Narcotic Butorphanol in Dog Surgery: In a study of 36 dogs undergoing laparotomy, splenectomy, or cystotomy, dogs were given meloxicam, ketoprofen, or butorphanol prior to surgery. Dogs in the butorphanol group received a second dose immediately after surgery. Pain scores (1 to 10) were assigned hourly for 20 hours after surgery and used to determine an overall efficacy score for each dog. Dogs with a pain score > or =3 were given oxymorphone for pain. Overall efficacy was rated as good or excellent in 9 of the 12 dogs that received meloxicam, compared with 9 of the 12 dogs that received ketoprofen and only 1 of the 12 dogs that received butorphanol. Safety and efficacy of preoperative administration of meloxicam, compared with that of ketoprofen and butorphanol in dogs undergoing abdominal surgery. Mathews KA, et al. University of Guelph, Canada.

Dog Surgery: NSAID Ketoprofen (Orudis) Did Better than Butorphanol for Post-Surgical Hind Limb Pain in Dogs: In a random-assignment study of 70 dogs undergoing orthopedic surgery on a hind limb, ketoprofen, oxymorphone hydrochloride, and butorphanol were compared for the control of postoperative pain. If the pain score was > or = 9, supplemental oxymorphone was administered IM. The ketoprofen alone and ketoprofen-oxymorphone groups did significantly better than the oxymorphone alone group. During the first hour after surgery, pain score was lower for oxymorphone alone and ketoprofen-oxymorphone groups than for ketoprofen or butorphanol alone groups. Significant differences were not detected among groups in regard to pain score 2 and 3 hours after surgery or in regard to arterial blood pressures at any time. From 4 to 12 hours after surgery, pain score was significantly lower for the ketoprofen alone group than for other groups. Except during the first hour after surgery, dogs given ketoprofen alone after elective orthopedic surgery had a greater level of, and longer-lasting, analgesia than did dogs given oxymorphone or butorphanol alone. Comparison of ketoprofen, oxymorphone hydrochloride, and butorphanol in the treatment of postoperative pain in dogs. Pibarot P, et al. University of Montreal, Canada. J Am Vet Med Assoc 1997 Aug 15;211(4):438-44. Ed: Ketoprofen (Orudis) is readily available in the U.S. for humans with a prescription for just $32 for 60 pills of 75 mg each, taken one three times a day. A long-acting form is available as Oruvail 200 mg once a day. The IM form is available as well. 

Cat Surgery: Non-Narcotic NSAID Carprofen Better than Butorphanol Which Was No Different Than Placebo: In a 24-hour DB study of 71 cats undergoing ovariohysterectomy, carprofen SC 4 mg/kg at induction, did much better than butorphanol SC 0.4 mg/kg at end of surgery. Butorphanol did not do significantly better than placebo in relieving pain. Authors state, "Carprofen provided better postsurgical analgesia than butorphanol." Comparison of preoperative carprofen and postoperative butorphanol as postsurgical analgesics in cats undergoing ovariohysterectomy. Al-Gizawly MM, et al. College of Veterinary Medicine, University of Minnesota. Vet Anaesth Analg 2004 Jul;31(3):164-74.

Children: Ear Surgery: Butorphanol Inferior to Ketoprofen But Better than Acetaminophen with Codeine: In a DB study of 120 children undergoing bilateral myringotomy and tube placement plain acetaminophen 10 mg/kg orally, was compared to acetaminophen 10 mg/kg with 1 mg/kg of codeine orally, transnasal butorphanol 25 micro g/kg given immediately after the induction of anesthesia, and ketorolac 1 mg/kg given IM immediately after the induction of anesthesia. All children received oral midazolam before surgery. IM ketorolac did best. Time to first rescue analgesic was longest in the ketorolac group, and there was no associated postoperative vomiting or nausea. Butorphanol provided superior analgesia when compared with acetaminophen with codeine or plain acetaminophen. Children who received ketorolac versus butorphanol had less vomiting in the 24 h after surgery. Postoperative analgesia in children undergoing myringotomy and placement equalization tubes in ambulatory surgery. Pappas AL, et al. Loyola University. apappas@lumc.edu. Anesth Analg 2003 Jun;96(6):1621-4.

Oxycone

Oxycone are yet other older opiates with similar dismal research.

Oxycone No Better than Indomethacin for Renal Colic: In a DB, cross-over study of 61 patients with acute renal colic, indomethacin (50 mg) IV did just as well as the narcotic oxycone-papaverine (5 mg + 50 mg) IV. Intravenous indomethacin and oxycone-papaverine in the treatment of acute renal colic. A double-blind study. Jonsson PE, et al. Br J Urol 1987 May;59(5):396-400. Ed: Oxycone is a semi-synthetic derivative of codeine, but more addictive than codeine.