Efficacy and Safety of Butorphanol Use in Patient-Controlled Analgesia: A Meta-Analysis

Zhihua Zhu,Wenyu Zhang,Ciara Hughes

doi:10.1155/2021/5530441

Zhihua Zhu, Wenyu Zhang + Show 1 more

Open Access

https://doi.org/10.1155/2021/5530441

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Abstract

Objective This meta-analysis evaluates the efficacy and safety regarding usage of butorphanol in patient-controlled analgesia (PCA). Methods Several databases such as PubMed, Cochrane Library, Embase, CNKI, and VIP were explored with the help of computer search and manual retrieval. Randomized controlled trial (RCT) was selected, and the meta-analysis was conducted using RevMan 5.1. The primary efficacy endpoint was the postoperative visual analog scale score, postoperative Ramsay sedation scale (RSS), and adverse events. Results Nine RCTs met the inclusion criteria and were included in this meta-analysis. No significant differences were found between the butorphanol group and nonbutorphanol group at 12 h and 48 h. The postoperative RSS score at 12 h, 24 h, and 48 h was representative of the calming effect of butorphanol. No significant difference was found on the endpoint of the postoperative RSS score at 12 h, 48 h, and 24 h. The RSS score was lower in the butorphanol group in comparison to the nonbutorphanol group. The butorphanol group was also associated with lower rate of nausea, vomiting, itching, and dizziness compared to the nonbutorphanol group. Conclusion Butorphanol may be used in PCA as a successful postoperative analgesia and is also associated with lower side effects. Further research is needed to verify the efficacy and safety of butorphanol.

Highlights

Several studies have demonstrated that butorphanol is beneficial in treating postoperative pain after cesarean section, dental surgery, and pain experienced by patients suffering from migraine headache, acute musculoskeletal pain, and biliary colic [4,5,6]
There are no studies that analyze the use of butorphanol in Patientcontrolled analgesia (PCA). is meta-analysis was undertaken to evaluate the efficacy and safety of butorphanol used in PCA
Study Selection. e inclusion criteria were as follows: (1) patients with postoperative pain; (2) butorphanol alone or in combination with other analgesics in the treatment group; (3) placebo or other analgesics except butorphanol in the control group; (4) the clinical outcomes of visual analog scale (VAS) score, Ramsay sedation scale (RSS) score, nausea, vomiting, itching, and dizzy were reported; (5) Randomized controlled trial (RCT) conducted in human beings

Summary

Introduction

2. Materials and Methods is meta-analysis was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) [7] protocols for conducting a high-quality study. E inclusion criteria were as follows: (1) patients with postoperative pain; (2) butorphanol alone or in combination with other analgesics in the treatment group; (3) placebo or other analgesics except butorphanol in the control group; (4) the clinical outcomes of visual analog scale (VAS) score, Ramsay sedation scale (RSS) score, nausea, vomiting, itching, and dizzy were reported; (5) RCTs conducted in human beings. Information regarding blinding, random sequence generation, allocation concealment, indications for incomplete outcome data, indications for selective reporting, and other biases were collected to evaluate the quality of the included investigations [8]. Data analyses were performed by Review Manager (RevMan) software (Version 5.1, e Cochrane Collaboration, Copenhagen, Denmark) and STATA software (Version 11.1, Stata Corp LP, College Station, TX, USA)

Results

Analgesic methods physical status

Conclusion