Liao Changjian, Li Guangyan, Chen Xiaojing, Liu Yingmei, Lu Zhongbo, Gao Jinglei, Huang Xiaofeng, Yang Xinping, Liu Zhiheng, Li Xiongjuan
Department of Anesthesiology, Shenzhen Second People's Hospital, The First Affiliated Hospital of Shenzhen University, Health Science Center, Shenzhen, People's Republic of China.
Department of Obstetrics, Shenzhen Second People's Hospital, The First Affiliated Hospital of Shenzhen University, Health Science Center, Shenzhen, People's Republic of China.
Pain Physician. 2025 Jul;28(4):329-336.
The analgesic effects between fentanyl, sufentanil, and butorphanol combined with flurbiprofen axetil on postoperative patient-controlled intravenous analgesia (PCIA) after cesarean delivery has never been evaluated.
To evaluate the postoperative analgesic efficacy of selected PCIA formulae.
This is a retrospective study.
Department of Anesthesiology, Shenzhen Second People's Hospital, a medical center in Shenzhen City, Guangdong Province, People's Republic of China.
From January 2022 through October 2023, the records of 463 patients who underwent a cesarean delivery were reviewed at Shenzhen Second People's hospital. All used a postoperative PCIA formula combined with flurbiprofen axetil and an antiemetic (ondansetron or tropisetron). The patients were placed into one of 3 groups: the Fentanyl Group (fentanyl plus flurbiprofen axetil plus ondansetron or tropisetron, 178 patients); the Sufentanil Group (sufentanil plus flurbiprofen axetil plus ondansetron or tropisetron, 159 patients); or the Butorphanol Group (butorphanol plus flurbiprofen axetil plus ondansetron or tropisetron, 126 patients). The primary data collected were the perioperative use of analgesics, postoperative Visual Analog Scale score, and no differences in adverse reactions were observed, except for the incidence of nausea and vomiting.
A significant difference was found between using epidural analgesics (such as morphine) and intravenous analgesics (such as butorphanol, flurbiprofen axetil, tramadol, parecoxib, and dexmedetomidine). There was no difference among the groups in postoperative Visual Analog Scale scores at 24 hours and 48 hours post cesarean delivery. There also was no difference in adverse reactions.
Our study was limited by a small sample size and did not differentiate the Visual Analog Scale scores between states of rest and movement.
The analgesic effect in patients who underwent cesarean delivery is similar when using different postoperative PCIA formulae. Although butorphanol displayed no analgesic advantage over fentanyl and sufentanil postoperatively, it caused fewer postoperative nausea and vomiting incidences than fentanyl and sufentanil.
从未评估过芬太尼、舒芬太尼和布托啡诺联合氟比洛芬酯用于剖宫产术后患者自控静脉镇痛（PCIA）的镇痛效果。
评估所选PCIA配方的术后镇痛效果。
这是一项回顾性研究。
中华人民共和国广东省深圳市的医疗中心——深圳市第二人民医院麻醉科。
2022年1月至2023年10月，深圳市第二人民医院回顾了463例行剖宫产术患者的记录。所有患者均使用了联合氟比洛芬酯和一种止吐药（昂丹司琼或托烷司琼）的术后PCIA配方。患者被分为3组之一：芬太尼组（芬太尼加氟比洛芬酯加昂丹司琼或托烷司琼，178例患者）；舒芬太尼组（舒芬太尼加氟比洛芬酯加昂丹司琼或托烷司琼，159例患者）；或布托啡诺组（布托啡诺加氟比洛芬酯加昂丹司琼或托烷司琼，126例患者）。收集的主要数据为围手术期镇痛药的使用情况、术后视觉模拟评分，除恶心和呕吐发生率外，未观察到不良反应有差异。
发现使用硬膜外镇痛药（如吗啡）和静脉镇痛药（如布托啡诺、氟比洛芬酯、曲马多、帕瑞昔布和右美托咪定）之间存在显著差异。剖宫产术后24小时和48小时，各组术后视觉模拟评分无差异。不良反应也无差异。
我们的研究受样本量小的限制，未区分静息和活动状态下的视觉模拟评分。
使用不同的术后PCIA配方时，剖宫产患者的镇痛效果相似。虽然布托啡诺术后在镇痛方面并不比芬太尼和舒芬太尼有优势，但它引起的术后恶心和呕吐发生率低于芬太尼和舒芬太尼。
