Comparing the Effects of Fentanyl, Sufentanil, and Butorphanol Combined With Flurbiprofen Axetil on Postoperative Intravenous Patient-controlled Analgesia Post Cesarean Delivery.

Background: The analgesic effects between fentanyl, sufentanil, and butorphanol combined with flurbiprofen axetil on postoperative patient-controlled intravenous analgesia (PCIA) after cesarean delivery has never been evaluated.

Objectives: To evaluate the postoperative analgesic efficacy of selected PCIA formulae.

Study Design: This is a retrospective study.

Setting: Department of Anesthesiology, Shenzhen Second People's Hospital, a medical center in Shenzhen City, Guangdong Province, People's Republic of China.

Methods: From January 2022 through October 2023, the records of 463 patients who underwent a cesarean delivery were reviewed at Shenzhen Second People's hospital. All used a postoperative PCIA formula combined with flurbiprofen axetil and an antiemetic (ondansetron or tropisetron). The patients were placed into one of 3 groups: the Fentanyl Group (fentanyl plus flurbiprofen axetil plus ondansetron or tropisetron, 178 patients); the Sufentanil Group (sufentanil plus flurbiprofen axetil plus ondansetron or tropisetron, 159 patients); or the Butorphanol Group (butorphanol plus flurbiprofen axetil plus ondansetron or tropisetron, 126 patients). The primary data collected were the perioperative use of analgesics, postoperative Visual Analog Scale score, and no differences in adverse reactions were observed, except for the incidence of nausea and vomiting.

Results: A significant difference was found between using epidural analgesics (such as morphine) and intravenous analgesics (such as butorphanol, flurbiprofen axetil, tramadol, parecoxib, and dexmedetomidine). There was no difference among the groups in postoperative Visual Analog Scale scores at 24 hours and 48 hours post cesarean delivery. There also was no difference in adverse reactions.

Limitations: Our study was limited by a small sample size and did not differentiate the Visual Analog Scale scores between states of rest and movement.

Conclusion: The analgesic effect in patients who underwent cesarean delivery is similar when using different postoperative PCIA formulae. Although butorphanol displayed no analgesic advantage over fentanyl and sufentanil postoperatively, it caused fewer postoperative nausea and vomiting incidences than fentanyl and sufentanil.