Comparison Of The Postoperative Analgesic Effects Of Patient-controlled Intravenous Analgesia With Different Analgesic Agent Combination For Cesarean Parturiants

Objective To compare the analgesic effects of patient-controlled intravenous analgesia with different analgesic agent combination for post-operative cesarean section to choose the optimal analgesic agent combination.Methods Sixty parturiants underwent cesarean section were randomly divided into three groups (n= 20). Analgesic solution (100ml) contained 8mg of butorphanol tartrate (group A) or 6 mg of butorphanol tartrate plus 32mg of lappaconitine hydrobromide (group B) or 0.015mg/kg of fentanyl citrate (group C), in addition of 10mg of tropisetron hydrochloride. In the end of procedure, 1mg of butorphanol (groups A and B) or 0.05mg of fentanyl (groups C) was intravenously injected followed by continuous pump infusion of analgesic solution in a rate of 2ml/h. Receivers pressed pump bottom as needed to get a bolus does of 0.5ml volume each time, with lockout time of 15min. Vital signs, visual analogue scales (VAS), Ramesy sedation score and adverse reactions were observed and recorded 1h,6h,12h,24h, 36h and 48h after procedure, respectively.Results (1) There were no significant differences among three groups in blood pressure, heart rate, breathing rate and pulse blood oxygen saturation at each time-point (P>0.05). (2) VAS value was lowest in group C and highest in group B (P<0.05) lh and 6h after procedure, and had no difference among three groups at postoperative 12h,24h,36h and 48h, with less 3 score for all the cases. (3) Ideal and similar Ramsey sedation score was recorded in the whole observation among three groups. (4) The times to press pump button was more in group A than that in groups B and C (P>0.05). (5) The occurrence of nausea, vomiting, headache and dizziness was more frequent in group C (P>0.05)than that in groups A and B.Conclusion The results of the present study demonstrates that PCIA using fentanyl (0.015mg/kg) produces powerful analgesic effect, as well as with frequent occurrence of adverse reactions. PCIA with butorphanol (8mg) exerts weak analgesic effect and rare adverse reactions. Combination of butorphanol (6mg) and lappaconitine (32mg) for PCIA provides both favorable analgesic effect and less adverse reactions, which is recommendable for clinical use.