Qiu Ling, Chen Xu-Hui, Fu Jia, Hua Lu, Fan Di, Zhang Ying-Ying, Wang Xiao-Bin
Department of Pain, Affiliated Hospital of Southwest Medical University, Luzhou, China.
Department of Anesthesiology, Affiliated Hospital of Southwest Medical University, Luzhou, China.
Medicine (Baltimore). 2024 Dec 27;103(52):e40887. doi: 10.1097/MD.0000000000040887.
Numerous studies have shown that butorphanol exerts an inhibitory effect on visceral pain. The aim of this study was to observe the effects of a single epidural administration of butorphanol combined with patient-controlled intravenous analgesia on postpartum uterine contraction pain after cesarean section.
We randomly allotted 121 women undergoing cesarean section surgery procedure to 3 groups: 31 cases were excluded; and 90 cases were divided into group S (blank control, n = 30), group I (intravenous butorphanol, n = 30), and group E (butorphanol administered into the epidural cavity, n = 30). We then observed changes in the indices of uterine contraction pain and intraoperative stretch pain for the 3 groups.
(1) In terms of the uterine contraction pain, the visual analog scale scores of group I were lower than those for group S at 10 minutes (P = .001), 20 minutes (P < .001), 30 minutes (P < .001), 1 hour (P < .001), 2 hours (P < .001), and 4 hours (P < .001) after the epidural administration. The visual analog scale scores of group E were lower than those of group I at 10 minutes (P < .001), 20 minutes (P < .001), 30 minutes (P < .001), 1 hour (P < .001), 2 hours (P < .001), 4 hours (P < .001), and 6 hours (P < .001) after the administration. (2) In terms of intraoperative traction reactions, sedation, and comfort during the operation, group E was superior to groups S and I at any time points (all P < .043).
Butorphanol single epidural administration combined with intravenous patient-controlled analgesia can effectively reduce the pain of uterine contraction and intraoperative traction reaction and improve perioperative comfort of the parturient.
大量研究表明,布托啡诺对内脏痛有抑制作用。本研究旨在观察单次硬膜外给予布托啡诺联合患者自控静脉镇痛对剖宫产术后子宫收缩痛的影响。
我们将121例行剖宫产手术的女性随机分为3组:排除31例;将90例分为S组(空白对照,n = 30)、I组(静脉注射布托啡诺,n = 30)和E组(硬膜外腔注入布托啡诺,n = 30)。然后观察3组子宫收缩痛和术中牵拉痛指标的变化。
(1)在子宫收缩痛方面,硬膜外给药后10分钟(P = .001)、20分钟(P < .001)、30分钟(P < .001)、1小时(P < .001)、2小时(P < .001)和4小时(P < .001),I组的视觉模拟评分低于S组。给药后10分钟(P < .001)、20分钟(P < .001)、30分钟(P < .001)、1小时(P < .001)、2小时(P < .001)、4小时(P < .001)和6小时(P < .001),E组的视觉模拟评分低于I组。(2)在术中牵拉反应、镇静和手术期间的舒适度方面,E组在任何时间点均优于S组和I组(均P < .043)。
布托啡诺单次硬膜外给药联合静脉患者自控镇痛可有效减轻子宫收缩痛和术中牵拉反应,提高产妇围手术期舒适度。