Application Of Low-dose Naloxone In The Post-operative Analgesia Of Butorphanol

Objective: To observe the influence of low-dose naloxone on the analgesic efficacy and adverse reactions of butorphanol used for the PCIA of puerperants.Methods: 80 puerperants undergone cesarean section with combined spinal-epidural anesthesia were randomly divided into 4 groups: Group N₀（0.14 mg/kg butorphanol and normal saline 100 ml）, Group N1(adding 0.10 μg·kg^-1·h^-1 naloxone based on Group N₀), Group N₂(adding 0.20 μg·kg^-1·h^-1 naloxone based on Group N₀), Group N₃(adding 0.30 μg·kg^-1·h^-1 naloxone based on Group N₀), 20 cases in each group. The scores of satisfaction of postoperative analgesia and visual analogue scales（VAS）, Ramsay sedation grades, respiratory depression, somnolence, dizziness, nausea, vomiting and pruritus were respectively recorded at 3 h, 6 h, 12 h, 24 h, 36 h and 48 h of the analgesia.Results:（1）There were no significant differences in the general data and VAS score between the 4 groups at each time point（P>0.05）, but the score of satisfaction of postoperative analgesia in Group N₀ and N1 was much lower than that in Group N₂ and N₃（P<0.05）; while the post-operation average stay in Group N₀ and N1 was obviously higher than that in Group N₂ and N₃（P<0.05）;（2）The Ramsay score in Group N₂ and N₃ was significantly lower than that in Group N₀ at each time point（P<0.05）. But compared with Group N1,the score in Group N₂ and N₃ was lower at 3 h（P<0.05）; The difference was absent between Group N₀ and N1 at 3 h（P>0.05）, but the score in Group N1 was lower than that in Group N₀ at the rest of the time points（P<0.05）;（3）The occurring rate of somnolence and dizziness in Group N₀ and that of nausea with vomit in Group N₀ and N1 was higher（P<0.05）. There was no case appearing respiratory depression and pruritus.Conclusion: There was no influence on the analgesic efficacy of butorphanol combined with low-dose naloxone for the patient-controlled intravenous analgesia of puerperants and the incidence rates of butorphanol’s adverse reactions including somnolence, dizziness, nausea and vomiting could be more effectively inhibited by 0.20⁰.30 μg·kg^-1·h^-1 naloxone.