China: A recent study has shown the effectiveness of dezocine in patient-controlled epidural analgesia (PCEA) in controlling pain associated with total myomectomy, has less impact on patients' sleep, and reduces the negative impact of stress factors, leading to fewer adverse effects. The findings were published online in the World Journal of Clinical Cases.
Uterine fibroids are frequently occurring benign gynecological conditions. Treatment typically involves medication for patients experiencing excessive menstruation, anemia, and pressure symptoms. In severe cases, a total hysterectomy may be necessary, although this procedure is invasive and can lead to significant postoperative pain. This discomfort may impact the patient's sleep quality after surgery, affecting the overall recovery process.

Patient-controlled epidural analgesia is a widely used method for self-administered pain relief, typically employing low concentrations of opioid analgesics. Morphine is currently the predominant choice due to its effective pain management capabilities. However, it can induce side effects such as nausea and vomiting, especially in patients undergoing total hysterectomy, possibly due to hormonal and endocrine factors. Dezocine, a phenylmorphanolane derivative, exhibits analgesic effects that correlate closely with dosage. Comparative studies evaluating equivalent analgesic doses of sufentanil, fentanyl, and dezocine have demonstrated that dezocine offers a better safety profile with less impact on consciousness levels and fewer adverse reactions.
Against the above background, Feng-Feng Ning, Department of Anesthesiology, Gansu Provincial Maternity and Child-care Hospital, Lanzhou, Gansu Province, China, and colleagues aimed to evaluate dezocine in patient-controlled epidural analgesia use for postoperative pain management in patients undergoing total myomectomy.
For this purpose, they selected 100 patients undergoing total abdominal hysterectomy for uterine fibroids. They randomized them into two groups; a control group received 0.2% ropivacaine plus 0.06 mg/mL of morphine, and an observation group received 0.2% ropivacaine plus 0.3 mg/mL of diazoxide in their PCEA. Outcomes evaluated included pain levels, recovery indices, sedation, stress factors, PCEA usage, and sleep quality.

The following were the key findings of the study:
The observation group showed lower visual analog scale scores, shorter postoperative recovery indices, fewer mean PCEA compressions, lower cortisol, and blood glucose levels, and better polysomnographic parameters than the control group.
The cumulative incidence of adverse reactions was lower in the observation group than in the control group.
The researchers conclude, "We explored the effectiveness of dezocine PCEA in pain management following total hysterectomy. Initial findings suggest that dezocine PCEA effectively alleviates post-procedural pain, mitigates the impact of stress factors, enhances sleep quality among patients, and reduces the incidence of adverse reactions. These outcomes offer significant implications for clinical anesthesia practices."
Reference:
Ning, Feng-Feng, et al. "Application of Dezocine Patient-controlled Epidural Analgesia in Postoperative Analgesia in Patients With Total Myomectomy." World Journal of Clinical Cases, vol. 12, no. 20, 2024, pp. 4265-4271.