Efficacy Of Butorphanol Analgesia In Caesarean Section

objectiveTo investigate the efficacy and side effects of butorphanol for analgesia in caesarean section.Material and Methods1. Case selection60 patients would be selected who needed selective caesarean section,pregnancy 37-42 weeks, ASAⅠ～Ⅱgrade, body weight 60～90kg, height 155～170cm. Without fatal distress, preeclampsia,and contraindications for anaesthesia.2. Grouping60 cases under going elective caesarean section were randomly divided into three groups:butorphanol group (group B),morphine group (group M) and control group (group C).3. Method and anesthesiaBlood pressure (BP), pulse (HR), oxygen saturation (SpO2) were monitored in the patients after entering into operation room. Combined spinal epidural anaesthesia were performed in three groups of patients.The Spinal needle was inserted into subarachnoid space through the epidural spinal needle after epidural anaesthesia was performed.0.5% bupivacaine (0.75% bupivacaine+NS2ml) was injected in subarachnoid space. epidural catheter was inserted toward the side of head after extrating the spinal needle. Patients in the group B received butorphanol lmg. The patients in the group M received 2mg morphine by epidural, butorphanol and morphine had been diluted to 5ml with NS. The patients in the group C received 5ml NS by epidural. 4. observed target(1) Neonatal Apgar scoring for lmin and 5min; the umbilical arterial blood gas values; Neonatal neurologic and Adaptive Capacity Scores (NACS) were assessed at 15min after birth (NACS);(2) The VAS scoring of exploration pain and uterine contration pain were recorded;(3) The VAS scoring 2hrs,4hrs,8hrs,12hrs,24hrs postop-eratively were recorded;(4) Side effects after operation were recorded.5. statistical analysisSPSS 13.0 was used to statistic, (?)±s was used to express measure data. Variance analysis was used to compare difference in the three groups. T test was used for measurement data. x2test was used for count data. There was s statistical difference when P＜0.05.Result1. There was no significant difference between three groups in neonatal Apgar scoring at 1min and 5min; there was no significant difference between three groups in the umbilical arterial blood gas values in PaO2,PaCO2,SpO2,PH;the Neonatal neurologic and Adaptive Capacity Scores (NACS) did not have the obvious difference (P＞0.05).2. The VAS scoring of exploration pain and uterine contraction pain during operation was lower in group B compared with that in group C (P＜0.05).3.The VAS scorning 2hrs,4hrs,8hrs,12hrs,24hrs was lower in group B and M compared with that in group C (p＜0.05). There was significant difference between group B and group M in VAS scorning 2hrs,4hrs,8hrs,12hrs,24hrs (P＞0.05).4. The incidences of side effects including pruritus,nausea, vomiting and respiratory depression were lower in group B than that in group M obviously (P＜0.05)ConclusionWe could conclude that butorphanol was satisfactoty and safe in caesarean section for postoperative analgesia, there was no adverse effects on neonatal and fewer side effects in patients. It is worth of clinical for butorphanol to be useed by epidural in caesarean section.