Continous Epidural Butorphanol Decreases the Incidence of Intrathecal Morphine-Related Pruritus After Cesarean Section: A Randomized, Double-Blinded, Placebo-Controlled Trial
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- 作者：Zhen Wu (1)
Mingjian Kong (1)
Jianqing Chen (1)
Laiyou Wen (1)
Jing Wang (1)
Jie Tan (2) - 关键词：Butorphanol ; Intrathecal morphine ; Pruritus
- 刊名：Cell Biochemistry and Biophysics
- 出版年：2014
- 出版时间：September 2014
- 年：2014
- 卷：70
- 期：1
- 页码：209-213
- 全文大小：179 KB
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Mingjian Kong (1)
Jianqing Chen (1)
Laiyou Wen (1)
Jing Wang (1)
Jie Tan (2)
1. Department of Anesthesia, Jiangyin Hospital, Medical College of Southeast University, No. 163, Shoushan Rd, Jiangyin, 214400, People’s Republic of China
2. Department of Obstetrics and Gynecology, Jiangyin Hospital, Medical College of Southeast University, Jiangyin, People’s Republic of China - ISSN：1559-0283
文摘
This randomized, double-blinded, placebo-controlled trial investigated the effect of continuous epidural butorphanol on intrathecal morphine-related pruritus in patients undergoing cesarean section. Eighty-three patients undergoing elective cesarean section under spinal anesthesia (1.5?mL of isobaric bupivacaine 0.5?% and 0.1?mg of preservative-free morphine) were enrolled in this study. Subjects were randomized to receive epidural butorphanol (n?=?43) or normal saline combined bupivacaine (n?=?40). In the study group, after the umbilical cord was clamped, patients were administered an epidural loading dose of 1?mg followed by a 48-h infusion of 0.004?% butorphanol with 0.1?% bupivacaine at a rate of 2?mL/h. In the normal saline group, saline was used for the loading dose and the infusion 0.1?% bupivacaine at a same rate. Postoperatively, a blinded observer recorded the incidence/severity of pruritus, visual analog pain scores and sedation level at 1, 3, 6, 9, 12, 24 and 48?h. The 48-h consumption of breakthrough analgesic (tramadol) was also noted. The primary outcome was the incidence of pruritus at 48?h. At 48?h, the incidence of pruritus was significantly lower in the butorphanol group (16.3 vs. 52.5?%; P?P?≤?.008). The pain scores were significantly lower at 12, 24 and 48?h (all P?P?=?0.014). In patients undergoing elective cesarean section, continuous epidural butorphanol with bupivacaine decreases the incidence and severity of intrathecal morphine-related pruritus without adversely affecting the quality of postoperative analgesia.