Skip to main content
NCBI home page
BMC Anesthesiology logoLink to BMC Anesthesiology
. 2025 Nov 19;25:576. doi: 10.1186/s12871-025-03472-6

Comparison of dezocine and hydromorphone in post-cesarean epidural analgesia: a retrospective study

Yang Cheng 1,2, Li-Si Mao 1,2,3, De-Ming Wang 1,2, Wen-Jie Liu 1,2, Yan Wang 1,2, Kun Liu 1,2, Xu-Yang Peng 1,2, Jia-Wen He 1,2, Rui-Yan Li 1,2, Ting Shen 1,2, Ying Chen 1,2, Yi Yang 1,2,✉
PMCID: PMC12628867  PMID: 41257623

Abstract

Background

Postoperative pain management following cesarean delivery is essential for optimizing maternal recovery and reducing complications. Patient-controlled epidural analgesia (PCEA) is widely used; however, the choice of opioid remains debated due to variations in effectiveness and side effect profiles. This study aims to compare the analgesic effectiveness and adverse effects of dezocine and hydromorphone in PCEA regimens for cesarean delivery.

Methods

In this retrospective study, 1,582 parturients who underwent cesarean delivery under neuraxial anesthesia and received postoperative PCEA between March 2019 and July 2022 were reviewed. 755 patients received dezocine (Group D) and 827 received hydromorphone (Group H). All patients received 250 mg ropivacaine compounded with either 10 mg dezocine or 4 mg hydromorphone, diluted to 250 ml. Primary outcomes included analgesic effectiveness (assessed via VAS scores, PCEA bolus frequency, and rescue analgesia rates) and adverse effects (nausea/vomiting, pruritus, lower limb numbness and motor block).

Results

Baseline demographic characteristics were comparable between groups (P > 0.05). Both groups showed comparable analgesic effectiveness with no significant differences in VAS scores (P = 0.29), PCEA bolus usage (P = 0.36), or need for rescue analgesia (P = 0.18). However, Group D experienced significantly fewer adverse effects. The incidence of nausea/vomiting was 16.9% in Group D vs. 28.1% in Group H (P < 0.001), and pruritus occurred in 12.3% vs. 24.8% (P < 0.001), respectively. No significant difference was observed in the incidence of lower limb numbness (P = 0.33) or motor block as assessed by Bromage score(P = 0.41).

Conclusions

Dezocine and hydromorphone demonstrated comparable analgesic effectiveness when administered via patient-controlled epidural analgesia (PCEA) following cesarean delivery. However, dezocine was associated with a significantly lower incidence of opioid-related adverse effects, indicating that it may serve as a safer and more tolerable alternative for postoperative pain management in obstetric patients.

Keywords: Cesarean, Patient-controlled epidural analgesia, Dezocine, Hydromorphone

Background

Postoperative pain management following cesarean delivery is essential for enhancing maternal recovery, reducing complications, and improving the overall postpartum experience [1]. As one of the most common surgeries worldwide, cesarean sections have a high incidence of postoperative pain, which, if inadequately controlled, can lead to prolonged recovery, increased risk of chronic pain, and higher rates of postpartum depression [2]. Given the significant physical and emotional impacts, effective analgesic strategies are critical in ensuring both short-term and long-term well-being of new mothers [3].

Neuraxial anesthesia is the predominant technique for cesarean delivery, thereby facilitating the use of patient-controlled epidural analgesia (PCEA) for postoperative pain management. PCEA is widely recognized for its effectiveness in managing post-cesarean pain and, compared with patient-controlled intravenous analgesia (PCIA), offers superior analgesia while reducing the incidence of nausea, vomiting, and respiratory depression [4, 5]. In clinical practice, PCEA regimens typically combine low-concentration local anesthetics with opioids. Ropivacaine is frequently selected for postoperative analgesia due to its rapid clearance, selective sensory-motor blockade, and enhanced cardiovascular safety [6]. However, the optimal opioid for inclusion in PCEA protocols remains a subject of ongoing debate [4, 7]. While morphine-a full µ-opioid receptor agonist-provides effective postoperative analgesia, its hydrophilic nature results in dose-dependent adverse effects, including pruritus, nausea, and vomiting [8, 9]. Hydromorphone, a semi-synthetic µ-opioid receptor agonist derived from morphine, offers a more favorable safety profile with a lower incidence of such adverse effects, yet its clinical outcomes are not uniformly optimal [10–13]. Striking a balance between achieving effective analgesia and minimizing adverse reactions remains a challenging issue in postoperative pain management.

Dezocine is a unique analgesic with a dual mechanism of action, functioning as a µ-opioid receptor partial agonist, κ-opioid receptor antagonist, and δ-opioid receptor agonist, while also inhibiting norepinephrine reuptake. This pharmacological profile enables it to provide effective pain relief with a lower incidence of opioid-related side effects compared to full µ-opioid agonists [14–16]. Clinical studies have demonstrated its effectiveness in acute, chronic, and postoperative pain management, with the potential for use as a standalone analgesic or in combination with other opioids to enhance analgesic effects while minimizing adverse effects [17–19]. These characteristics make dezocine a promising alternative in multimodal pain management strategies. We hypothesize that dezocine, when used in a PCEA regimen, provides comparable analgesic effectiveness to hydromorphone, but with a lower incidence of opioid-related adverse effects in post-cesarean patients.

However, to date, no studies have directly compared hydromorphone and dezocine in the context of PCEA following cesarean delivery. Therefore, this study aims to evaluate and compare the effectiveness and safety profiles of these two opioids, each combined with ropivacaine, in post-cesarean PCEA regimens. The objective is to determine which regimen achieves optimal pain control with fewer adverse events, thereby improving recovery and overall maternal outcomes. By addressing this knowledge gap, we aim to provide evidence-based guidance for optimizing epidural analgesia strategies in obstetric practice.

Methods

Study design and population

The Ethics Review Committee of the Second Affiliated Hospital of the University of South China approved this study and waived the requirement for informed consent (approval number: 2024006). We used an institutional patient-controlled analgesia (PCA) follow-up database to identify parturients who underwent cesarean delivery under neuraxial anesthesia and received postoperative epidural patient-controlled analgesia between March 2019 and July 2022. To compare the analgesic effectiveness of dezocine and hydromorphone in epidural analgesia, we retrospectively included cases in which patients received epidural infusions consisting of ropivacaine in combination with either dezocine or hydromorphone. According to published literature, the analgesic effectiveness of dezocine is comparable to that of morphine [20, 21]. Hydromorphone is approximately 2 to 3 times more potent than morphine in terms of analgesic effect [22, 23]. Based on these relative potency ratios, 10 mg of dezocine is generally considered equianalgesic to 4 mg of hydromorphone. Therefore, only cases were included where 250 mg of ropivacaine was compounded with either 10 mg dezocine (Group D) or 4 mg hydromorphone (Group H), with the final solution diluted with sterile normal saline to a total volume of 250 ml for continuous epidural administration. Parturients with comorbidities (American society of Anesthesiologists (ASA) ≥ III), missing data for any key study variables (VAS score, PCEA bolus count, rescue analgesia use, or adverse effects), gestational age less than 37 weeks, or premature dislodgement of the epidural catheter were excluded.

Implementation and data collection

All cesarean sections were performed under combined spinal-epidural anesthesia (CSEA). A standard dose of 13–16 mg of 0.5% isobaric ropivacaine(ropivacaine was diluted with cerebrospinal fluid)was administered intrathecally for spinal anesthesia. All parturients received PCEA for postoperative analgesia following cesarean section. Parturients in the D group received 0.1% ropivacaine combined with 40 µg/ml dezocine, while those in the H group received 0.1% ropivacaine combined with 16 µg/ml hydromorphone, administered at a basal infusion rate of 5 ml/h. The patient-controlled bolus was set to deliver 1.5 ml of analgesic solution with a lockout interval of 15 min and a maximum of 10 ml per hour. If parturients continued to require supplemental analgesia after increasing the PCA pump dose, diclofenac sodium suppositories were administered rectally for rescue analgesia. The analgesia pump was evaluated by the anesthesia nurse at 24 h after cesarean delivery, with all parameters systematically documented.

Demographic characteristics were collected, including age, weight, height, body mass index (BMI), gestational age, multiple pregnancy, previous cesarean, duration of surgery and duration of hospital stay.

Analgesic effectiveness assessment

The primary outcomes of the present study were analgesic effectiveness and the incidence of adverse effects. Postoperative analgesic effectiveness was assessed during the routine anesthesia follow-up visit at 24 h after cesarean delivery. This evaluation integrated both subjective and objective parameters to provide a comprehensive assessment of pain control. Pain intensity was measured at this time using the visual analog scale (VAS), with scores ranging from 0 (no pain) to 10 (worst imaginable pain). Additionally, the number of PCEA boluses administered was recorded as the cumulative total over the first 24 h, reflecting the frequency of breakthrough pain and the need for supplemental analgesia beyond the basal infusion. Rescue analgesia was administered according to a standard institutional protocol: parturients with VAS ≥ 4 at rest or on movement, despite PCEA, were given rectal diclofenac sodium, and the total use of rescue analgesia was documented over the same 24-hour period.

Assessment of adverse effects

The incidence of adverse effects was determined as the cumulative occurrence over the first 24 h after cesarean delivery and included nausea/vomiting, pruritus, and lower limb numbness. Lower limb numbness was defined as hypoesthesia-diminished sensation to light touch, pinprick, or temperature-typically reported by patients as reduced skin sensitivity or numbness in the lower extremities. Motor function was assessed separately at 24 h postoperatively using the 4-point Bromage scale: 4 = full movement of both legs; 3 = unable to raise the extended leg but able to bend the knee; 2 = unable to bend the knee but able to flex the ankle; 1 = no movement of both legs [24]. Clinical symptoms associated with the analgesic regimen were evaluated and documented through direct nursing observations and electronic medical records within the first 24 h.

Statistical analysis

All statistical analyses were performed using GraphPad Prism version 10 software (GraphPad Inc., CA, USA). A two-sided P-value < 0.05 was considered statistically significant. Continuous variables were expressed as means ± standard deviations (SD) for normally distributed data or as medians (interquartile range, IQR) for non-normally distributed data, while categorical variables were presented as frequencies and percentages. The Shapiro-Wilk test was used to assess normality of continuous data. For group comparisons, independent t-tests were applied to normally distributed continuous variables, whereas the Mann-Whitney U test was used for non-normally distributed data. Categorical variables were compared using the Chi-square test.

Results

A total of 1,582 parturients met the inclusion criteria for this retrospective review, with 755 patients receiving dezocine (Group D) and 827 receiving hydromorphone (Group H) (Fig. 1). Baseline demographic characteristics were comparable between the two groups; there were no significant differences in age, weight, height, BMI, gestational age, incidence of multiple pregnancy, history of prior cesarean delivery, or duration of surgery (Table 1).

Fig. 1.

Fig. 1

Open in a new tab

Study flow diagram

Table 1.

Patient demographics

Group D (n = 755) Group H (n = 827) P-value
Age, years 31 [28–33] 30 [27–34] 0.68
Weight, kg 68.3 ± 8.3 68.8 ± 7.7 0.22
Height, cm 158.6 ± 5.9 159.3 ± 5.7 0.34
BMI, kg/m2 26.9 ± 2.9 27.3 ± 2.7 0.24
Gestational age, weeks 39 [38.4–39.7] 39.1 [38.3–39.7] 0.90
Multiple pregnancy 13 (1.7%) 14 (1.7%) 0.96
Previous cesarean 476 (63.1%) 481 (58.3%) 0.06
Duration of surgery, min 72.7 ± 16.2 73.5 ± 17.9 0.31
Open in a new tab

Data are presented as mean (standard deviation), n (%), or median [IQR] as appropriate

BMI Body mass index

As shown in Table 2, there were no significant differences in analgesic effectiveness between the two groups. Both groups exhibited similar VAS pain scores (P = 0.29), comparable numbers of PCEA boluses (P = 0.36), and an equivalent proportion of patients requiring rescue analgesia (P = 0.18). These findings collectively suggest that both analgesic regimens provided equivalent pain control in the postoperative period. Similarly, there was no significant difference in the length of hospital stay between the two groups, with both groups demonstrating a median stay of 5 days (P = 0.15).

Table 2.

Comparison of pain management and hospital stay between the two groups

Group D (n = 755) Group H (n = 827) P-value
VAS score 2 [1–2] 2 [1–2] 0.29
PCEA bolus 2 [0–3] 2 [0–4] 0.36
Patients required rescue analgesia 175 (23.2%) 168 (20.3%) 0.18
Hospital stay, days 5 [4–6] 5 [4–6] 0.15
Open in a new tab

Data are presented as n (%), or median [IQR] as appropriate

VAS Visual analog scale, PCEA Patient-controlled epidural analgesia

In contrast to the similarities in analgesic effectiveness, the incidence of adverse effects varied notably between the two treatment groups (Table 3). The incidence of nausea and vomiting was significantly lower in Group D (16.9%; 95% CI, 14.3–19.6) compared to Group H (28.1%; 95% CI, 25.0–31.2), with a statistically significant difference (P < 0.001) and a mean absolute risk reduction of 11.2% (95% CI, − 15.2% to − 7.1%). A similar pattern was observed for pruritus, which occurred in 12.3% (95% CI, 10.0–14.7) of patients in Group D and 24.8% (95% CI, 21.9–27.8) in Group H (P < 0.001), corresponding to a mean difference of − 12.5% (95% CI, − 16.3% to − 8.7%). No statistically significant difference was observed in the incidence of lower limb numbness between the two groups (P = 0.33). No parturients in either group had a Bromage score of 1. Scores of 2, 3, and 4 occurred in 20 (2.6%), 54 (7.2%), and 681 (90.2%) parturients in Group D, and in 18 (2.2%), 73 (8.8%), and 736 (89.0%) parturients in Group H, respectively. The distribution did not differ significantly (P = 0.41).

Table 3.

Comparison of adverse effects between the two groups

Group D (n = 755) Group H (n = 827) P-value
Nausea/Vomiting 128 (16.9%) 232 (28.1%) < 0.001
Pruritus 93 (12.3%) 205 (24.8%) < 0.001
Lower Limb Numbness 72 (9.5%) 67 (8.1%) 0.33
Motor Block (Bromage Score) 0.41
 4 681 (90.2%) 736 (89.0%)
 3 54 (7.2%) 73 (8.8%)
 2 20 (2.6%) 18 (2.2%)
 1 0 (0.0%) 0 (0.0%)
Open in a new tab

Data are presented as n (%)

Discussion

Effective postoperative pain management following cesarean delivery is vital for enhancing maternal recovery, facilitating early mobilization, and improving the overall postpartum experience. This retrospective study directly compared the effectiveness and adverse effects of two opioid agents-dezocine and hydromorphone-when combined with ropivacaine in patient-controlled epidural analgesia (PCEA). While both regimens achieved comparable analgesic effectiveness, they differed significantly in their adverse effect profiles.

Our findings demonstrate that both hydromorphone and dezocine regimens provided equivalent analgesia, as evidenced by similar VAS pain scores, PCEA bolus frequency, and rescue analgesia requirements. These results are consistent with previous studies. For instance, Yang et al. showed that epidural hydromorphone with ropivacaine achieved satisfactory analgesia post-cesarean delivery [25], while Li et al. confirmed its equivalence to morphine in analgesic effect with a more favorable onset profile [26]. Dezocine, on the other hand, has been shown to provide effective epidural analgesia across various surgical settings including myomectomy and abdominal surgery, and exhibits an additional benefit in modulating norepinephrine reuptake [14, 27, 28].

Importantly, our study revealed that dezocine was associated with significantly fewer adverse effects, including nausea/vomiting and pruritus. These findings are clinically important, particularly in obstetric populations, where minimizing maternal discomfort and facilitating early ambulation and breastfeeding are key priorities. Although hydromorphone has previously been considered a safer alternative to morphine due to its reduced hydrophilicity and shorter duration of side effects, accumulating evidence suggests that it still carries a non-negligible burden of adverse reactions [7, 12, 23]. A meta-analysis demonstrated that intrathecal hydromorphone is significantly associated with an increased risk of pruritus, despite offering some analgesic benefit [7]. Similarly, in a randomized controlled trial, epidural administration of hydromorphone in patients undergoing episiotomy resulted in a significantly higher incidence of nausea and pruritus compared to the saline control group [29]. In contrast, the multimodal pharmacologic profile of dezocine, including partial µ-agonism and κ-antagonism, likely contributes to its lower incidence of adverse effects. Previous study showed that dezocine and morphine have similar effectiveness for cancer pain, but dezocine causes fewer adverse reactions [20]. A recent randomized controlled trial on labor analgesia reported findings consistent with ours [30]. Compared with the µ-opioid receptor agonist sufentanil, epidural dezocine was associated with a significantly lower incidence of pruritus, while achieving comparable analgesic efficacy as indicated by similar VAS scores and onset times [30]. Additionally, the dezocine group demonstrated a longer duration of analgesia and required fewer bolus doses, suggesting a more sustained analgesic effect [30]. Collectively, these findings support the role of dezocine as an effective and well-tolerated analgesic in both labor and post-cesarean epidural regimens, particularly with regard to reducing pruritus and other opioid-related adverse effects.

Another important consideration is the potential impact of analgesic regimens on maternal satisfaction, sleep quality, and mental health-all essential dimensions of postpartum care. Several clinical studies have associated dezocine with reductions in postoperative anxiety, depression, and inflammatory response, further supporting its role in enhanced recovery after cesarean Sects [31, 32]. Although our retrospective design did not include such patient-centered outcomes, these findings warrant further investigation in prospective trials.

This study has several limitations. First, as a retrospective analysis, it is inherently susceptible to selection and information bias, despite comparable baseline characteristics between groups. Second, the fixed dosing (dezocine 10 mg vs. hydromorphone 4 mg) precludes detailed exploration of dose–response relationships. Third, long-term outcomes such as breastfeeding success, maternal satisfaction, or chronic pain incidence were not evaluated. Fourth, the type of cesarean incision (transverse vs. vertical) was not consistently recorded, limiting our ability to control for its potential impact on postoperative pain. Lastly, lower limb numbness was recorded based on subjective nursing notes without standardized sensory classification (e.g., hypoesthesia vs. paresthesia), and data on its incidence, duration, and severity were not consistently documented across study groups. This limits accurate interpretation and between-group comparison of this neurologic outcome.

Conclusions

This study confirms that dezocine and hydromorphone provide equivalent postoperative analgesia following cesarean delivery when used in PCEA with ropivacaine. However, dezocine offers a superior safety profile, with significantly fewer opioid-related side effects. Given its dual receptor activity, favorable tolerability, and potential benefits in emotional recovery, dezocine represents a compelling alternative to traditional µ-opioid agonists for post-cesarean epidural analgesia. Future prospective randomized trials are warranted to confirm these results and further explore dezocine’s role in multimodal, patient-centered analgesic strategies for obstetric surgery.

Acknowledgements

Not applicable.

Abbreviations

PCEA

Patient-controlled epidural analgesia

PCIA

Patient-controlled intravenous analgesia

ASA

American Society of Anesthesiologists

BMI

Body mass index

VAS

Visual analog scale

SD

Standard deviation

IQR

Interquartile range

CI

Confidence interval

Authors’ contributions

YC and LSM contributed to data collection and drafting the manuscript. DMW and WJL assisted with clinical data sorting. YW and KL contributed in analyzing the data, XYP and JWH contributed to manuscript revision, RYL contributed to data interpretation. TS and YC provided critical revision. YY designed this study and was the major contributor in writing the manuscript. All authors read and approved the final manuscript.

Funding

This work was supported by the Natural Science Foundation of Hunan Province (2023JJ60353, 2025JJ81005, 2025JJ81022), Health Research Project of Hunan Provincial Health Commission (202217014497, B202317018313).

Data availability

The datasets used and/or analyzed during the current study are available from the corresponding author on reasonable request.

Declarations

Ethics approval and consent to participate

This study was approved by the Ethics Review Committee of the Second Affiliated Hospital of the University of South China (approval number: 2024006). The requirement for informed consent was waived by the committee due to the retrospective design of the study and the use of de-identified patient data. All methods were conducted in accordance with relevant institutional and national guidelines.

Consent for publication

Not applicable.

Competing interests

The authors declare no competing interests.

Footnotes

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

References

  • 1.Komatsu R, Ando K, Flood PD. Factors associated with persistent pain after childbirth: a narrative review. Br J Anaesth. 2020;124(3):e117–30. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 2.Froeliger A, Deneux-Tharaux C, Loussert L, Bouchghoul H, Laure Sutter-Dallay A, Madar H, Sentilhes L. Prevalence and risk factors for postpartum depression 2 months after Cesarean delivery: a prospective multicenter study. Am J Obstet Gynecol. 2024;S0002–9378(24):01103–7. [DOI] [PubMed] [Google Scholar]
  • 3.Mori Y, Toyama S, Sato M, Yamashita Y, Suzuki Y, Sago H. Influence of preterm labour epidural analgesia on neonatal and maternal outcomes: a single-centre retrospective study. Br J Anaesth. 2021;127(5):e154–6. [DOI] [PubMed] [Google Scholar]
  • 4.Chang CY, Tu YK, Kao MC, Shih PC, Su IM, Lin HY, Chien YJ, Wu MY, Chen CH, Chen CT. Effects of opioids administered via intravenous or epidural patient-controlled analgesia after caesarean section: A network meta-analysis of randomised controlled trials. EClinicalMedicine. 2023;56:101787. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 5.Liu H, Wang Z, Zhang Y, Zhang Y, Zhang Y, Tang S. Comparison of patient-controlled epidural analgesia and epidural morphine for post-cesarean section analgesia: experience from a tertiary center in China. J Anesth. 2024;38(5):650–5. [DOI] [PubMed] [Google Scholar]
  • 6.Leone S, Di Cianni S, Casati A, Fanelli G. Pharmacology, toxicology, and clinical use of new long acting local anesthetics, ropivacaine and Levobupivacaine. Acta Biomed. 2008;79(2):92–105. [PubMed] [Google Scholar]
  • 7.Grape S, El-Boghdadly K, Jaques C, Albrecht E. Efficacy and safety of neuraxial hydromorphone: A systematic review and meta-analysis with trial sequential analysis. J Clin Anesth. 2024;99:111664. [DOI] [PubMed] [Google Scholar]
  • 8.Lewald H, Girard T. Analgesia after Cesarean section - what is new? Curr Opin Anaesthesiol. 2023;36(3):288–92. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 9.Kianian S, Bansal J, Lee C, Zhang K, Bergese SD. Perioperative multimodal analgesia: a review of efficacy and safety of the treatment options. Anesthesiology Perioperative Sci. 2024;2(1):9.
  • 10.Sviggum HP, Arendt KW, Jacob AK, Niesen AD, Johnson RL, Schroeder DR, Tien M, Mantilla CB. Intrathecal hydromorphone and morphine for postcesarean delivery analgesia: determination of the ED90 using a sequential allocation Biased-Coin method. Anesth Analg. 2016;123(3):690–7. [DOI] [PubMed] [Google Scholar]
  • 11.Bansback N, Guh D, Oviedo-Joekes E, Brissette S, Harrison S, Janmohamed A, Krausz M, MacDonald S, Marsh DC, Schechter MT, et al. Cost-effectiveness of hydromorphone for severe opioid use disorder: findings from the SALOME randomized clinical trial. Addiction. 2018;113(7):1264–73. [DOI] [PubMed] [Google Scholar]
  • 12.Beatty NC, Arendt KW, Niesen AD, Wittwer ED, Jacob AK. Analgesia after Cesarean delivery: a retrospective comparison of intrathecal hydromorphone and morphine. J Clin Anesth. 2013;25(5):379–83. [DOI] [PubMed] [Google Scholar]
  • 13.Duan G, Bao X, Yang G, Peng J, Wu Z, Zhao P, Zuo Z, Li H. Patient-controlled intravenous Tramadol versus patient-controlled intravenous hydromorphone for analgesia after secondary Cesarean delivery: a randomized controlled trial to compare analgesic, anti-anxiety and anti-depression effects. J Pain Res. 2018;12:49–59. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 14.Chen Y, Lu Y, Xiang X, Fu L, Liu Y, Li C, Sun J. Efficacy and safety analysis of Midazolam combined with Dezocine sedation and analgesia colonoscopy in patients with inflammatory bowel disease: a prospective single-center open study. Front Pharmacol. 2023;14:1150045. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 15.Ye RR, Jiang S, Xu X, Lu Y, Wang YJ, Liu JG. Dezocine as a potent analgesic: overview of its Pharmacological characterization. Acta Pharmacol Sin. 2022;43(7):1646–57. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 16.Zhu J, Xu C, Wang X, Shi W. Comparison of the analgesic effects of dezocine, Tramadol and Butorphanol after Cesarean section. Pak J Pharm Sci. 2018;31(5Special):2191–5. [PubMed] [Google Scholar]
  • 17.Chen Z, Jiang K, Liu F, Zhu P, Cai F, He Y, Jin T, Lin Z, Li Q, Hu C, et al. Safety and efficacy of intravenous hydromorphone patient-controlled analgesia versus intramuscular Pethidine in acute pancreatitis: an open-label, randomized controlled trial. Front Pharmacol. 2022;13:962671. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 18.Deng B, Wang D, Xie Z, Wang Y, Huang L, Jiang M, Shen T. Comparison of the analgesic effect of Dezocine and Esketamine in combination with sufentanil respectively after laparoscopic cholecystectomy: a prospective randomized controlled study. BMC Anesthesiol. 2024;24(1):51. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 19.Ning FF, Yao TT, Wang XX. Application of Dezocine patient-controlled epidural analgesia in postoperative analgesia in patients with total myomectomy. World J Clin Cases. 2024;12(20):4265–71. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 20.Wang L, Liu X, Wang J, Sun Y, Zhang G, Liang L. Comparison of the efficacy and safety between Dezocine injection and morphine injection for persistence of pain in Chinese cancer patients: a meta-analysis. Biosci Rep. 2017;37(3):BSR20170243. [DOI] [PMC free article] [PubMed]
  • 21.Zhou X, Zhang C, Wang M, Yu L, Yan M. Dezocine for preventing postoperative pain: A Meta-Analysis of randomized controlled trials. PLoS ONE. 2015;10(8):e0136091. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 22.Cao X, Gui Q, Wei Y, Lan L, Xiao H, Wen S, Li X. The 50% effective dose of hydromorphone and morphine for epidural analgesia in the hemorrhoidectomy: a double-blind, sequential dose-finding study. BMC Anesthesiol. 2024;24(1):41. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 23.Sharpe EE, Molitor RJ, Arendt KW, Torbenson VE, Olsen DA, Johnson RL, Schroeder DR, Jacob AK, Niesen AD, Sviggum HP. Intrathecal morphine versus intrathecal hydromorphone for analgesia after Cesarean delivery: A randomized clinical trial. Anesthesiology. 2020;132(6):1382–91. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 24.Xu L, Li S, Zhang C, Zhou Y, Chen X. Esketamine administered epidurally as an adjuvant to epidural ropivacaine for labour analgesia: a prospective, double-blind dose-response study. BMJ Open. 2024;14(11):e071818. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 25.Yang M, Wang L, Chen H, Tang Y, Chen X. Postoperative Analgesic Effects of Different Doses of Epidural Hydromorphone Coadministered with Ropivacaine after Cesarean Section: A Randomized Controlled Trial. Pain Res Manag. 2019;2019:9054538. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 26.Li Y, Yue X, Liang S, Ren F, Guo Q, Zou W. Effectiveness and safety of hydromorphone compared to morphine for postoperative analgesia: A systematic review and Meta-analysis. Pain Physician. 2024;27(8):469–78. [PubMed] [Google Scholar]
  • 27.Li Q, Yao H, Xu M, Wu J. Dexmedetomidine combined with sufentanil and dezocine-based patient-controlled intravenous analgesia increases female patients’ global satisfaction degree after thoracoscopic surgery. J Cardiothorac Surg. 2021;16(1):102. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 28.Li XT, Ma CQ, Qi SH, Zhang LM. Combination of Propofol and Dezocine to improve safety and efficacy of anesthesia for gastroscopy and colonoscopy in adults: A randomized, double-blind, controlled trial. World J Clin Cases. 2019;7(20):3237–46. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 29.Lu Y, Liu S, Jing S, Peng W, Lin Y. Epidural injection of hydromorphone for postoperative pain after episiotomy: a randomized controlled trial. Sci Rep. 2024;14(1):24704. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 30.Su B, Qian P, Zhang WP, Hou Y, Shen Y. Effects of Dezocine with ropivacaine on epidural analgesia during labor: a randomized controlled trial. Front Pharmacol. 2025;16:1586393. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 31.Zhao P, Wu Z, Li C, Yang G, Ding J, Wang K, Wang M, Feng L, Duan G, Li H. Postoperative analgesia using Dezocine alleviates depressive symptoms after colorectal cancer surgery: A randomized, controlled, double-blind trial. PLoS ONE. 2020;15(5):e0233412. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 32.Zhu R, Du T, Gao H. Effects of Dezocine and ropivacaine infiltration anesthesia on cellular immune function indicators, anesthesia recovery time and pain factors in patients with open liver resection. Cell Mol Biol. 2020;66(3):149–54. [PubMed] [Google Scholar]

Associated Data

This section collects any data citations, data availability statements, or supplementary materials included in this article.

Data Availability Statement

The datasets used and/or analyzed during the current study are available from the corresponding author on reasonable request.

Articles from BMC Anesthesiology are provided here courtesy of BMC

RESOURCES