title: Butorphanol use in laboring patients with preeclampsia or chronic hypertension.
abstract: OBJECTIVE
  The American College of Obstetricians and Gynecologists (ACOG) recommends against the use of butorphanol in patients diagnosed with preeclampsia or chronic hypertension secondary to a theoretical concern that the drug will further elevate blood pressures. No past study has examined the drug's potential to elevate blood pressures in laboring patients.
  
  
  METHODS
  In this retrospective cohort study all chronic hypertensive and preeclamptic patients who underwent an induction of labor and delivered a viable, singleton pregnancy between the dates of 1/1/2013 and 12/31/2014 at a single academic hospital were included.
  
  
  RESULTS
  The use of butorphanol in chronically hypertensive patients during labor was not associated with the presence of severe range blood pressures during labor (OR=0.92 95% CI: (0.04-19.34) P=0.96). In preeclamptic patients there was similarly no change in the frequency of severe range blood pressures with the use of the drug (OR=0.59 95% CI: (0.19-1.83) P=0.36).
  
  
  CONCLUSIONS
  In laboring patients with chronic hypertension or preeclampsia butorphanol is not associated with severe range blood pressures, and therefore it is a reasonable option for providing pain relief in these populations.
authors.affiliation: Pennsylvania State University Milton S Hershey Medical Center in Hershey, PA, United States. Electronic address: kgapply@yahoo.com.
authors.forename: Kelly
authors.initials: K
authors.lastname: Garrity
authors.affiliation: Pennsylvania State University Milton S Hershey Medical Center in Hershey, PA, United States. Electronic address: ajang@hmc.psu.edu.
authors.forename: Allyson
authors.initials: A
authors.lastname: Jang
authors.affiliation: Pennsylvania State University Milton S Hershey Medical Center in Hershey, PA, United States. Electronic address: swagner2@hmc.psu.edu.
authors.forename: Steve
authors.initials: S
authors.lastname: Wagner
mesh_terms: D000328:Adult; D000701:Analgesics, Opioid / Q000494:pharmacology* / Q000627:therapeutic use; D001034:Apgar Score; D001794:Blood Pressure / Q000187:drug effects*; D002077:Butorphanol / Q000494:pharmacology* / Q000627:therapeutic use; D002908:Chronic Disease; D005260:Female; D006801:Humans; D006973:Hypertension / Q000503:physiopathology*; D015931:Intensive Care, Neonatal; D007751:Labor, Induced; D007743:Labor, Obstetric / Q000502:physiology; D011225:Pre-Eclampsia / Q000503:physiopathology*; D011247:Pregnancy; D012189:Retrospective Studies
chemical_list: D000701:Analgesics, Opioid; D002077:Butorphanol
keywords: Butorphanol; Chronic hypertension; Preeclampsia