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硬膜外分娩镇痛的进展:布托啡诺的有效性及治疗策略

Advances in epidural labor analgesia: Effectiveness and treatment strategies of butorphanol.

作者信息

Yu Wan-Qiu, Zhu Zhao-Qiong, Tang Fu-Shan

机构信息

Department of Anesthesiology, Affiliated Hospital of Zunyi Medical University, Zunyi 563003, Guizhou Province, China.

Early Clinical Research Ward, Affiliated Hospital of Zunyi Medical University, Zunyi 563003, Guizhou Province, China.

出版信息

World J Clin Cases. 2024 Dec 6;12(34):6669-6673. doi: 10.12998/wjcc.v12.i34.6669.

Abstract

In this editorial, we provide a critical review of the article by Tang published in the , focusing on the utilization of butorphanol for epidural analgesia during labor. Our discussion encompasses recent research developments in epidural labor analgesia, specifically highlighting the current status of clinical applications of butorphanol and associated treatment approaches. Epidural analgesia is widely acknowledged as the primary method for pain management during labor, offering effective and prolonged pain relief while allowing mothers to remain alert and actively participate in the delivery process. Among the various drugs utilized for epidural labor analgesia, butorphanol has received increasing attention due to its potential efficacy and distinctive pharmacological properties. As a synthetic opioid analgesic, butorphanol exhibits both agonistic and antagonistic activity on opioid receptors, striking a balance between analgesia and minimizing side effects. Nevertheless, the safety and efficacy of butorphanol in epidural labor analgesia remains controversial. While certain studies have reported positive outcomes with butorphanol, including effective pain relief and a reduced incidence of side effects, others have raised concerns about its safety and efficacy compared to traditional opioids or alternative analgesics. In addition, the optimal dosing strategy and regimen of butorphanol as an adjuvant in epidural labor analgesia still need to be verified. Through comprehensive synthesis and analysis of existing literature, we aim to evaluate the current evidence regarding the use of butorphanol for epidural labor analgesia, delineate areas of consensus and controversy, and propose future avenues for research and clinical practice in this domain.

摘要

在这篇社论中,我们对Tang发表在《 》上的文章进行了批判性综述,重点关注布托啡诺在分娩期间硬膜外镇痛中的应用。我们的讨论涵盖了硬膜外分娩镇痛的最新研究进展,特别强调了布托啡诺的临床应用现状及相关治疗方法。硬膜外镇痛被广泛认为是分娩期间疼痛管理的主要方法,能提供有效且持久的疼痛缓解,同时让母亲保持清醒并积极参与分娩过程。在用于硬膜外分娩镇痛的各种药物中,布托啡诺因其潜在疗效和独特的药理特性而受到越来越多的关注。作为一种合成阿片类镇痛药,布托啡诺对阿片受体兼具激动和拮抗活性,在镇痛与最小化副作用之间取得平衡。然而,布托啡诺在硬膜外分娩镇痛中的安全性和有效性仍存在争议。虽然某些研究报告了布托啡诺的积极结果,包括有效的疼痛缓解和副作用发生率降低,但与传统阿片类药物或其他镇痛药相比,其他研究对其安全性和有效性提出了担忧。此外,布托啡诺作为硬膜外分娩镇痛辅助药物的最佳给药策略和方案仍需验证。通过对现有文献的全面综合和分析,我们旨在评估关于布托啡诺用于硬膜外分娩镇痛的当前证据,明确共识和争议领域,并提出该领域未来的研究和临床实践方向。

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