Analgesic and Sedative Effects of Different Doses of Dexmedetomidine Combined with Butorphanol in Continuous Analgesia after a Cesarean Section

Abstract

ObjectiveThe present study is designed to study the analgesic and sedative effect of different doses of dexmedetomidine combined with butorphanol in continuous analgesia after a cesarean section.MethodsA total of 60 puerperae undergoing a cesarean section recruited from a single center were divided into three groups according to the postoperative continuous analgesia protocol: control group (100 mL of normal saline containing 10 µg/kg fentanyl and 0.25 mg of palonosetron, 2 mL/h for continuous analgesia for 48 h), DB1 group (100 mL of normal saline containing 1.0 µg/kg dexmedetomidine, 4 mg of butorphanol, 10 µg/kg fentanyl, and 0.25 mg of palonosetron, 2 mL/h for continuous analgesia for 48 h), and DB2 group (100 mL normal saline containing 2.0 µg/kg dexmedetomidine, 4 mg of butorphanol, 10 µg/kg fentanyl, and 0.25 mg of palonosetron, 2 mL/h for continuous analgesia for 48 h). We compared the blood pressure, heart rate, oxygen saturation, VAS score, Ramsay score, and adverse reactions of puerperae among the three groups after surgery.ResultsThe baseline data all have no significant difference in the three groups (p > 0.05). Compared with those in the control group, the systolic blood pressure, diastolic blood pressure, heart rate, and VAS score of the puerperae in the DB1 group and DB2 group were significantly decreased at 6, 24, and 48 h (P < 0.05), while the Ramsay scores of the puerperae in DB1 group and DB2 group were significantly increased at 6, 24, and 48 h (p < 0.05). At the same time, the systolic blood pressure, diastolic blood pressure, heart rate, and VAS score of the puerperae in the DB2 group were significantly lower than those in the DB1 group (P < 0.05), while the Ramsay scores of the puerperae in DB2 group were significantly higher than those in the DB1 group (P < 0.05). Also, there is no significant difference in oxygen saturation and adverse reactions of puerperae among the three groups after surgery (p > 0.05).ConclusionDexmedetomidine combined with butorphanol can improve the analgesic and sedative effects in continuous analgesia after a cesarean section, and the analgesic and sedative effects of dexmedetomidine in the high-dose group are better than those in the low-dose group.

The Efficacy of Low-Dose Esketamine and Butorphanol in Treating Depression and Pain After Cesarean Section

“…This mechanism results in central sedative and anxiolytic effects [15] . Earlier studies highlighted that different doses of dexmedetomidine combined with butorphanol post-cesarean section could enhance sustained analgesia [16,17] . Notably, higher doses exhibited superior analgesic outcomes without significant changes in sedation effects.…”

Advances in the Use of Butorphanol Tartrate in Postoperative Analgesia after Cesarean Section

“…also increases, so the use of PCIA pumped Butorphanol application in post-cesarean section will be very beneficial [45] . Liu H et al found that continuous pumping of butorphanol tartrate was effective in relieving uterine contraction pain in primary caesarean section, and its reliable sedation could avoid postoperative pain hypersensitivity due to sleep deprivation [46] . Mothers with scarred uterus are more sensitive to pain, and the pain caused by postoperative uterine contractions is more intense, PCIA continuous infusion of Butorphanol can also achieve satisfactory analgesic and sedative effects for mothers with second cesarean section, and when used in combination with other opioids, it can also reduce the total opioid dosage and lower the incidence of adverse effects [47,48] .Qin C et al also demonstrated that for repeat intolerable postoperative uterine spasmodic pain in women undergoing cesarean section, the application of Butorphanol tartrate in PCIA provided better analgesia and accelerated postoperative recovery [48] .…”