Butorphanol For Preventing The Side-effects Of Epidural Morphine After Cesarean Section

Objective:To evaluate the effect of butorphanol for preventing the side-effects of epidural morphine after Cesarean section.Methods:90 patients(ASA I-II) undergoing Cesarean section were enrolled in a randomized double-blinded study.All the patients received patient-controlled eidural analgesia (PCEA) with the analgetic solution of 0.15%bupivacaine 100ml which contains morphine 4mg.The PCEA were programmed with a loading dose of additional morphine 2mg,background infusion 2ml/h and a bolus dose 1.0ml, the lockout time is 15min.After the delivery,1mg butorphanol IV in group B(n=30); l0mg dexamethasone IV in group D(n=30); and 2ml saline were used as control in group N(n=30),all these were given through the Murphy's Dropper. BP,RR, ECG and SpO2 of all the patients were monitored continuously during the operation; VAS Scores were observed timely, the cases that need to press the PCA button,and the analgesia time of each patient were noted;the cases and severity of PONV and pruritus, the BCS and the degree of satisfaction with analgesia of all the patients were recorded at the end of analgesia.Results:①All the patients of the three groups got satisfaction analgetic effect, there were no significant difference in VAS among the three groups(P>0.05);but we notice in group B, the cases need to press the PCA button were less than other two groups (P＜0.05),the analgesia time of 100ml solution also last longer in group B than other two groups (P<0.05).②The cases of nausea and vomiting in group B and group D were obviously less than that in group N(P<0.01, P<0.05),between the group B and group N,there were no significant difference;the cases of pruritus in group B and group D was obviously less than that in group N(P<0.01),between the group B and group N,there were no significant difference; all the three groups had no respiratory depression.③The BCS scores in group B and group D were obviously higher than that in group N(P<0.01),and the score in group B was higher than group D, too(P<0.05).The patients of group B got more satisfaction with analgesia among the three groups, (P<0.05).Conclusion:The butorphanol is effective in preventing PONV and pruritus associated with morphine during PCEA., without increasing the respiratory depression; And it can make patient feel more comfortable and satisfaction.