Effect of butorphanol nasal spray administration on patient cooperativity during labor epidural placement: a single-center randomized controlled trial

Abstract Background Epidural block stands as the prevailing, secure, and efficient approach to labor analgesia. Inadequate maternal cooperation not only hampers anesthesia effectiveness but also may lead to severe consequences, including nerve damage due to positional changes. Methods A randomized c...

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Main Authors: Jing Sun, Fan Wu, Mingguang Wu, Guanxiong Wu, Zhao Zheng, Gehui Li, Xiaoguang Wang, Xiaolei Huang, Yuantao Li
Format: Article
Language:English
Published: BMC 2025-05-01
Series:Perioperative Medicine
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Online Access:https://doi.org/10.1186/s13741-025-00535-7
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author Jing Sun
Fan Wu
Mingguang Wu
Guanxiong Wu
Zhao Zheng
Gehui Li
Xiaoguang Wang
Xiaolei Huang
Yuantao Li
author_facet Jing Sun
Fan Wu
Mingguang Wu
Guanxiong Wu
Zhao Zheng
Gehui Li
Xiaoguang Wang
Xiaolei Huang
Yuantao Li
author_sort Jing Sun
collection DOAJ
description Abstract Background Epidural block stands as the prevailing, secure, and efficient approach to labor analgesia. Inadequate maternal cooperation not only hampers anesthesia effectiveness but also may lead to severe consequences, including nerve damage due to positional changes. Methods A randomized controlled clinical trial with 200 participants was conducted to compare painless delivery with epidural alone versus a combination of butorphanol nasal spray preceding epidural administration for painless delivery. The objective was to assess the combined approach’s efficacy in diminishing maternal pain and enhancing maternal compliance. Results Within 8-min post-anesthesia, the combined analgesic group (EXP group) exhibited significantly lower maternal pain intensity scores, improved maternal cooperation, reduced visual analogue scale (VAS) pain, and McGill scores compared to the epidural alone group (CTRL group). No statistically significant differences emerged in 24-h postpartum blood loss, labor duration, or lactation period. Neonatal indicators, including umbilical artery blood PCO2, base excess of extracellular fluid (BE-ecf), weight, and Apgar score, showed no significant differences between the EXP and CTRL groups. However, the EXP group demonstrated a higher umbilical artery blood pH than the CTRL group. The EXP group exhibited significantly higher probabilities of pain intensity scores ≤ 6, maternal cooperation scores ≤ 3, VAS scores ≤ 3 at 6-, 8-, and 10-min post-anesthesia, and McGill scores of 0 compared to the CTRL group. Conclusion Butorphanol nasal spray emerges as an effective means to alleviate pain during epidural puncture in labor analgesia, markedly improving maternal anesthesia adherence. This combined analgesic method proves to be a safe and efficacious approach for maternal pain relief during labor.
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spelling doaj-art-26b86fdfbb884a89af08b4e5453e97692025-08-20T03:08:43ZengBMCPerioperative Medicine2047-05252025-05-0114111710.1186/s13741-025-00535-7Effect of butorphanol nasal spray administration on patient cooperativity during labor epidural placement: a single-center randomized controlled trialJing Sun0Fan Wu1Mingguang Wu2Guanxiong Wu3Zhao Zheng4Gehui Li5Xiaoguang Wang6Xiaolei Huang7Yuantao Li8Department of Anesthesiology, Shenzhen Futian District Maternal and Child Health HospitalDepartment of Anesthesiology, Shenzhen Maternity & Child Healthcare Hospital, The First School of Clinical Medicine, Southern Medical UniversityDepartment of Anesthesiology, Shenzhen Maternity & Child Healthcare Hospital, The First School of Clinical Medicine, Southern Medical UniversityDepartment of Anesthesiology, Shenzhen Maternity & Child Healthcare Hospital, The First School of Clinical Medicine, Southern Medical UniversityDepartment of Anesthesiology, Shenzhen Maternity & Child Healthcare Hospital, The First School of Clinical Medicine, Southern Medical UniversityDepartment of Anesthesiology, Shenzhen Maternity & Child Healthcare Hospital, The First School of Clinical Medicine, Southern Medical UniversityDepartment of Anesthesiology, Shenzhen Maternity & Child Healthcare Hospital, The First School of Clinical Medicine, Southern Medical UniversityDepartment of Anesthesiology, Shenzhen Maternity & Child Healthcare Hospital, The First School of Clinical Medicine, Southern Medical UniversityDepartment of Anesthesiology, Shenzhen Maternity & Child Healthcare Hospital, The First School of Clinical Medicine, Southern Medical UniversityAbstract Background Epidural block stands as the prevailing, secure, and efficient approach to labor analgesia. Inadequate maternal cooperation not only hampers anesthesia effectiveness but also may lead to severe consequences, including nerve damage due to positional changes. Methods A randomized controlled clinical trial with 200 participants was conducted to compare painless delivery with epidural alone versus a combination of butorphanol nasal spray preceding epidural administration for painless delivery. The objective was to assess the combined approach’s efficacy in diminishing maternal pain and enhancing maternal compliance. Results Within 8-min post-anesthesia, the combined analgesic group (EXP group) exhibited significantly lower maternal pain intensity scores, improved maternal cooperation, reduced visual analogue scale (VAS) pain, and McGill scores compared to the epidural alone group (CTRL group). No statistically significant differences emerged in 24-h postpartum blood loss, labor duration, or lactation period. Neonatal indicators, including umbilical artery blood PCO2, base excess of extracellular fluid (BE-ecf), weight, and Apgar score, showed no significant differences between the EXP and CTRL groups. However, the EXP group demonstrated a higher umbilical artery blood pH than the CTRL group. The EXP group exhibited significantly higher probabilities of pain intensity scores ≤ 6, maternal cooperation scores ≤ 3, VAS scores ≤ 3 at 6-, 8-, and 10-min post-anesthesia, and McGill scores of 0 compared to the CTRL group. Conclusion Butorphanol nasal spray emerges as an effective means to alleviate pain during epidural puncture in labor analgesia, markedly improving maternal anesthesia adherence. This combined analgesic method proves to be a safe and efficacious approach for maternal pain relief during labor.https://doi.org/10.1186/s13741-025-00535-7Epidural blockEpidural punctureLabor analgesiaButorphanol nasal sprayPain
spellingShingle Jing Sun
Fan Wu
Mingguang Wu
Guanxiong Wu
Zhao Zheng
Gehui Li
Xiaoguang Wang
Xiaolei Huang
Yuantao Li
Effect of butorphanol nasal spray administration on patient cooperativity during labor epidural placement: a single-center randomized controlled trial
Perioperative Medicine
Epidural block
Epidural puncture
Labor analgesia
Butorphanol nasal spray
Pain
title Effect of butorphanol nasal spray administration on patient cooperativity during labor epidural placement: a single-center randomized controlled trial
title_full Effect of butorphanol nasal spray administration on patient cooperativity during labor epidural placement: a single-center randomized controlled trial
title_fullStr Effect of butorphanol nasal spray administration on patient cooperativity during labor epidural placement: a single-center randomized controlled trial
title_full_unstemmed Effect of butorphanol nasal spray administration on patient cooperativity during labor epidural placement: a single-center randomized controlled trial
title_short Effect of butorphanol nasal spray administration on patient cooperativity during labor epidural placement: a single-center randomized controlled trial
title_sort effect of butorphanol nasal spray administration on patient cooperativity during labor epidural placement a single center randomized controlled trial
topic Epidural block
Epidural puncture
Labor analgesia
Butorphanol nasal spray
Pain
url https://doi.org/10.1186/s13741-025-00535-7
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