Postoperative patient-controlled analgesia with butorphanol in puerperants underwent cesarean section

Abstract

Objective To compare the effect of postoperative patient-controlled intravenous analgesia(PCIA) with doses of butorphanol on puerperant after cesarean section. Methods Three hundred ASA Ⅰ or Ⅱ patients underwent cesarean section were randomly divided into 6 groups(n=50) respectively received tramadol 200.0 μg·kg-1·h-1(group T), butorphanol 3.0 μg·kg-1·h-1 (group B1), butorphanol 3.5 μg·kg-1·h-1(group B2), butorphanol 4.0 μg·kg-1·h-1(group B3), butorphanol 4.5 μg·kg-1·h-1(group B4), or butorphanol 5.0 μg·kg-1·h-1(group B5). The loading doses were 50 mg for tramadol in group T, and 0.5 mg for butorphanol in group B1-B5, and PCIA was initiated after operation. VAS and observer's assessment of alertness/sedation(OAA/S) scale were employed to assess the severity of rest pain, motion pain, and uterus systole pain before anesthesia(T0), 0(T1), 30 min(T2), 2 h(T3), 4 h(T4), 24 h(T5) and 48 h(T6) after the initiation of PCIA. The time to flatus, time to breastfeeding, time to lactation, side effects, and satisfaction scores were recorded. Results Compared with group T, VAS scores of rest pain, motion pain, and uterus systole pain at T5 in group B1 were higher(P 0.05). No differences were found in pain scores at T6 among 6 groups(P>0.05). Compared with group T, patients in group B1 need more PCIA bolus during T5-T6(P 0.05). Conclusions PCIA with butorphanol at a dose of 3.5 μg·kg-1·h-1 or 4.0 μg·kg-1·h-1 may provide optimal postoperative analgesia after cesarean section. Key words: Butorphanol; Cesarean section; Patient-controlled intravenous analgesia