Intravenous butorphanol as an adjunct to patient-controlled epidural analgesia with ropivacaine and sufentanil in labor: a randomized controlled study

Background: Butorphanol was safely used for obstetric analgesia for many years. We attempted to determine if it increases the analgesic effect during patient-controlled epidural labor analgesia (PCEA) and if it affects the labor-process. Methods: Term pregnant women (N = 60) were randomly assigned t...

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Main Authors: Ting Zhou, FengYuan Nong, MengXia Wang, ZhaoJia Liang, YaLan Li
Format: Article
Language:English
Published: IMR Press 2022-03-01
Series:Clinical and Experimental Obstetrics & Gynecology
Subjects:
Online Access:https://www.imrpress.com/journal/CEOG/49/3/10.31083/j.ceog4903060
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author Ting Zhou
FengYuan Nong
MengXia Wang
ZhaoJia Liang
YaLan Li
author_facet Ting Zhou
FengYuan Nong
MengXia Wang
ZhaoJia Liang
YaLan Li
author_sort Ting Zhou
collection DOAJ
description Background: Butorphanol was safely used for obstetric analgesia for many years. We attempted to determine if it increases the analgesic effect during patient-controlled epidural labor analgesia (PCEA) and if it affects the labor-process. Methods: Term pregnant women (N = 60) were randomly assigned to two groups, to receive either 1 mg intravenously butorphanol or 10 mL normal saline as placebo at 10 min before intrathecal anesthesia. Pain score, duration of first and second stage of labor, mode of delivery, umbilical artery blood gas, Apgar scores and adverse effects were recorded. Result: Butorphanol shortened the duration of the second stage of labor (t = –2.41, p = 0.019). Women in butorphanol group showed significantly increased incidence of pruritus (x2 = 20.32, p = 0.000), but they also showed significantly increased incidence of the adverse events such as maternal somnolence and dizziness (x2 = 8.366, p = 0.004; x2 = 26.447, p = 0.000 respectively). The pain scores of the two groups showed a linear reduction within 1 h (F = 8.878, p = 0.004), and from intravenous injection of butorphanol to the 5th minute after intrathecal analgesia, the analgesic scores of butorphanol group were significantly lower than those of placebo group (p < 0.05). At the third hour after intrathecal injection, the Visual analogue scale (VAS) score was significantly lower in butorphanol group than placebo group (95% Confidence Interval (CI) –3.02 to –0.28; t = –2.51, p = 0.021). Conclusions: i.v. butorphanol 1 mg alleviates the labor pain during intrathecal puncture, and It will be easier to get the cooperation of pregnant women and shortens the second stage of labor. It effectively relieved the pruritus, but increased the incidence of dizziness and somnolence.
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spelling doaj.art-908bcc43ed34415bb49d8ee4d0aeb2e92022-12-22T02:11:15ZengIMR PressClinical and Experimental Obstetrics & Gynecology0390-66632022-03-014936010.31083/j.ceog4903060S0390-6663(22)01712-2Intravenous butorphanol as an adjunct to patient-controlled epidural analgesia with ropivacaine and sufentanil in labor: a randomized controlled studyTing Zhou0FengYuan Nong1MengXia Wang2ZhaoJia Liang3YaLan Li4The Department of Anesthesiology, The First Affiliated Hospital of Jinan University, Jinan University, 510630 Guangzhou, Guangdong, ChinaThe Department of Anesthesiology, Yue Bei People’s Hospital, 512025 Shaoguan, Guangdong, ChinaThe Department of Anesthesiology, The First Affiliated Hospital of Jinan University, Jinan University, 510630 Guangzhou, Guangdong, ChinaThe Department of Anesthesiology, The First Affiliated Hospital of Jinan University, Jinan University, 510630 Guangzhou, Guangdong, ChinaThe Department of Anesthesiology, The First Affiliated Hospital of Jinan University, Jinan University, 510630 Guangzhou, Guangdong, ChinaBackground: Butorphanol was safely used for obstetric analgesia for many years. We attempted to determine if it increases the analgesic effect during patient-controlled epidural labor analgesia (PCEA) and if it affects the labor-process. Methods: Term pregnant women (N = 60) were randomly assigned to two groups, to receive either 1 mg intravenously butorphanol or 10 mL normal saline as placebo at 10 min before intrathecal anesthesia. Pain score, duration of first and second stage of labor, mode of delivery, umbilical artery blood gas, Apgar scores and adverse effects were recorded. Result: Butorphanol shortened the duration of the second stage of labor (t = –2.41, p = 0.019). Women in butorphanol group showed significantly increased incidence of pruritus (x2 = 20.32, p = 0.000), but they also showed significantly increased incidence of the adverse events such as maternal somnolence and dizziness (x2 = 8.366, p = 0.004; x2 = 26.447, p = 0.000 respectively). The pain scores of the two groups showed a linear reduction within 1 h (F = 8.878, p = 0.004), and from intravenous injection of butorphanol to the 5th minute after intrathecal analgesia, the analgesic scores of butorphanol group were significantly lower than those of placebo group (p < 0.05). At the third hour after intrathecal injection, the Visual analogue scale (VAS) score was significantly lower in butorphanol group than placebo group (95% Confidence Interval (CI) –3.02 to –0.28; t = –2.51, p = 0.021). Conclusions: i.v. butorphanol 1 mg alleviates the labor pain during intrathecal puncture, and It will be easier to get the cooperation of pregnant women and shortens the second stage of labor. It effectively relieved the pruritus, but increased the incidence of dizziness and somnolence.https://www.imrpress.com/journal/CEOG/49/3/10.31083/j.ceog4903060butorphanolintrathecal anesthesialabor painpatient controlled epidural analgesiavisual analogue scaleropivacainesufentanyl
spellingShingle Ting Zhou
FengYuan Nong
MengXia Wang
ZhaoJia Liang
YaLan Li
Intravenous butorphanol as an adjunct to patient-controlled epidural analgesia with ropivacaine and sufentanil in labor: a randomized controlled study
Clinical and Experimental Obstetrics & Gynecology
butorphanol
intrathecal anesthesia
labor pain
patient controlled epidural analgesia
visual analogue scale
ropivacaine
sufentanyl
title Intravenous butorphanol as an adjunct to patient-controlled epidural analgesia with ropivacaine and sufentanil in labor: a randomized controlled study
title_full Intravenous butorphanol as an adjunct to patient-controlled epidural analgesia with ropivacaine and sufentanil in labor: a randomized controlled study
title_fullStr Intravenous butorphanol as an adjunct to patient-controlled epidural analgesia with ropivacaine and sufentanil in labor: a randomized controlled study
title_full_unstemmed Intravenous butorphanol as an adjunct to patient-controlled epidural analgesia with ropivacaine and sufentanil in labor: a randomized controlled study
title_short Intravenous butorphanol as an adjunct to patient-controlled epidural analgesia with ropivacaine and sufentanil in labor: a randomized controlled study
title_sort intravenous butorphanol as an adjunct to patient controlled epidural analgesia with ropivacaine and sufentanil in labor a randomized controlled study
topic butorphanol
intrathecal anesthesia
labor pain
patient controlled epidural analgesia
visual analogue scale
ropivacaine
sufentanyl
url https://www.imrpress.com/journal/CEOG/49/3/10.31083/j.ceog4903060
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