Butorphanol Nasal Spray Relieves Pain and Distress in Women Under Epidural Labor Analgesia: A Randomized Controlled Trial

Background: Epidural block is currently the most widely used, safe, and effective method of labor analgesia. Poor maternal anesthesia cooperation not only influences the effect of the anesthesia but also causes serious adverse consequences, including nerve damage due to changes in body position. Methods A randomized controlled clinical trial that included 200 participants comparing painless delivery with epidural alone versus a combination of butorphanol nasal spray prior to an epidural for painless delivery was conducted to evaluate the efficacy of the combination in reducing maternal pain and increasing maternal compliance. Results The maternal pain intensity score, maternal cooperation, Visual Analogue Scale (VAS) pain, and emotional score within 8 min after anesthesia results were significantly lower in the combined analgesic group (EXP group) compared to the epidural alone group (CTRL group). There were no statistically significant differences in 24-hour postpartum blood loss, labor duration, or lactation period. Neonatal-related indicators such as umbilical artery blood PCO 2 , base excess of extracellular fluid (BE-ecf) weight, and Apgar score were not significantly different between the EXP and CTRL groups. However, the umbilical artery blood pH in the EXP group was higher compared to the CTRL group. In the EXP group, the probabilities of pain intensity scores ≤ 6, probability of maternal cooperation scores ≤ 3, VAS scores ≤ 3 at 6, 8, and 10 minutes after anesthesia, and emotional scores of 0 were significantly higher compared to the CTRL group. Conclusion Butorphanol nasal spray can effectively relieve the pain of epidural puncture during labor analgesia, significantly improve the degree of maternal anesthesia adherence, and is a safe and effective method for combined maternal analgesia.