Background: Butorphanol was safely used for obstetric analgesia for
many years. We attempted to determine if it increases the analgesic effect during
patient-controlled epidural labor analgesia (PCEA) and if it affects the
labor-process. Methods: Term pregnant women (N = 60) were randomly
assigned to two groups, to receive either 1 mg intravenously butorphanol or 10 mL
normal saline as placebo at 10 min before intrathecal anesthesia. Pain score,
duration of first and second stage of labor, mode of delivery, umbilical artery
blood gas, Apgar scores and adverse effects were recorded. Result:
Butorphanol shortened the duration of the second stage of labor (t = –2.41,
p = 0.019). Women in butorphanol group showed significantly increased
incidence of pruritus (x = 20.32, p = 0.000), but they
also showed significantly increased incidence of the adverse events such as
maternal somnolence and dizziness (x = 8.366, p = 0.004;
x = 26.447, p = 0.000 respectively). The pain scores of
the two groups showed a linear reduction within 1 h (F = 8.878, p =
0.004), and from intravenous injection of butorphanol to the 5th minute after
intrathecal analgesia, the analgesic scores of butorphanol group were
significantly lower than those of placebo group (p 0.05). At the
third hour after intrathecal injection, the Visual analogue scale (VAS) score was significantly lower in
butorphanol group than placebo group (95% Confidence Interval (CI) –3.02 to –0.28; t = –2.51,
p = 0.021). Conclusions: i.v. butorphanol 1 mg alleviates the
labor pain during intrathecal puncture, and It will be easier to get the
cooperation of pregnant women and shortens the second stage of labor. It
effectively relieved the pruritus, but increased the incidence of dizziness and
somnolence.