Abstract
Background: Efficient maternal pain relief after cesarean delivery remains challenging, but it is important to improve outcomes for the mother and the newborn during the puerperium. We compared the analgesic effect of nalbuphine (a κ receptor agonist/μ receptor antagonistic) with that of sufentanil (a µ-receptor agonist) in patient-controlled intravenous analgesia (PCIA) after cesarean section.Methods: We enrolled 84 patients scheduled for elective cesarean sections with spinal anesthesia and randomized them into either nalbuphine or sufentanil groups (42 patients each). Pain scores, PCIA drug consumptions, degree of satisfaction, and adverse events were recorded as outcome measures.Results: The pain scores at rest and uterine cramping pain scores in the nalbuphine group were lower than those in the sufentanil group at 6, 12, and 24 h after the operation. Also, the pain scores while switching to a seated position were lower in the nalbuphine group than in the sufentanil group at 6 and 12 h after the operation (p < 0.05). We found no significant differences in the PCIA drug consumption between the two groups. The degree of satisfaction in patients in the nalbuphine group was higher than that of patients in the sufentanil group (p = 0.01). Adverse events did not differ in the two groups.Conclusion: PCIA with nalbuphine provides better analgesia and higher patient satisfaction than sufentanil after cesarean section.
Highlights
It is well-known that surgical procedures are a common cause of acute pain (Robert et al, 2015), and cesarean section is one the most common inpatient surgery performed worldwide (Eisenach et al, 2008)
Primipara patients scheduled for elective lower segment cesarean section with spinal anesthesia between January 2017 and May 2017 were enrolled in the trial
We found no statistically significant difference in patient-controlled intravenous analgesia (PCIA) drug consumption (Figure 5) and PCIA bolus times between the Sufentanil Nalbuphine p value group(n = 41) group(n = 41)
Summary
It is well-known that surgical procedures are a common cause of acute pain (Robert et al, 2015), and cesarean section is one the most common inpatient surgery performed worldwide (Eisenach et al, 2008). Owing to significant trauma of the internal organs caused by the cesarean section, effective analgesia in the post-operative period can be challenging. The uterine contraction agent used after the procedure to promote uterine involution and reduce postoperative hemorrhages can supplement the noxious stimuli and cause cramping pain (Lavand’homme, 2006). Inadequate pain control can have several adverse effects in patients undergoing surgery. We compared the analgesic effect of nalbuphine (a κ receptor agonist/μ receptor antagonistic) with that of sufentanil (a μ-receptor agonist) in patient-controlled intravenous analgesia (PCIA) after cesarean section
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