Abstract: Objective To investigate the analgesic effect of butorphanol in outpatient hysteroscopy. Methods From 2018 to 2019,110 outpatients who underwent hysteroscopy in our center were randomly divided into two groups:55 cases in butorphanol group (group N) and 55 cases in fentanyl + midazolam group (group F).Patients in the group N were injected with Butorphanol (0.02 mg/kg),and those in the group F with fentanyl 2μg/kg and imidazole (0.02 mg/kg).After 5-10 min,patients in each group were given propofol (1-2 mg/kg).Blood pressure was recorded at 3 min,5 min and 10 min after administration of butorphanol or fentanyl,respectively.Meanwhile,the loading dose of propofol,the total dosage of propofol,the duration of operation,the cervical response,respiratory depression,wake-up time after operation,wake-up score,uterine contraction pain within 30min after operation and adverse reactions were recorded. Results Two cases in group N and 4 cases in group F were dropped out.There was no significant difference in wake-up time (2.45±0.85min vs2.16±0.83min) and cervical response (1.8% vs 3.9%) between the group N and the group F (P>0.05);while the blood pressure in both groups decreased after the drug took effect,and it was significantly lower in the group N compared to the group F (P<0.05).The postoperative uterine contraction pain in the group N was significantly lower than that in the group F (0.17±0.64 vs 0.71±1.15,P=0.004),while the wake-up score in group F was superior to that in group N (4.90±0.46 vs4.58±0.50,P=0.001),and the propofol dosage in group F was also significantly less than that in group N (213.73±47.11mg vs258.40±33.73mg,P<0.001). Conclusion For patients undergoing hysteroscopic surgery,butorphanol provide better effect on postoperative uterine contraction pain management,similar wake-up time and cervical response.