OBJECTIVE： To observe the analgesic efficacy of Fentanyl transdermal patch versus Butorphanol nasal spray for morphine intolerant patients with advanced cancer and its effect on related indicators. METHODS： 64 morphine intolerant patients with advanced cancer were randomly divided into fentanyl group （32 cases） and butorphanol group （32 cases）. Based on the dose of oral morphine， all patients changed the dose of Fentanyl transdermal patch and Butorphanol nasal spray. Morphine dose 100 mg/d＝Fentanyl transdermal patch 1 mg/d＝Butorphanol nasal spray 1 mg/d. Fentanyl group was given 1 Fentanyl transdermal patch， replaced once every 72 h； butorphanol group was given 1 Butorphanol tartrate nasal spray， sprayed every 24 h. If the analgesic effect was poor， then self-controlled with fentanyl intravenously for analgesia， until it was controlled and adverse reaction relieved， and dose was decreased in self-controlled analgesia if there were intolerable adverse reactions. Both groups were given continuous medication for 10 d. Analgesic effects， pain scores， 5-hydroxytryptamine （5-HT）， norepinephrine （NE）， and scores of life quality （general status，daily activities，emotions，walk，social eontact，sleep） before and after treatment， and the incidence of adverse reactions in 2 groups were observed. RESULTS： The total effective rate in fentanyl group was significantly higher than butorphanol group， with statistic significance （P＜0.05）. Before treatment， there were no significant differences in pain scores， 5-HT， NE level， scores of life quality and the incidence of adverse reactions in 2 groups （P＞0.05）. After treatment， pain scores， 5-HT， NE level， scores of life quality and the incidence of adverse reactions in 2 groups were significantly lower than before， pain scores， 5-NT， NE level， general status scores， daily activities scores， emotions  scores and entertainment  scores and the incidence of dizziness and sleepiness in fentanyl group were significantly lower than butorphanol group， with statistic significances （P＜0.05）. CONCLUSIONS： Fentanyl transdermal patch is superior to Butorphanol nasal spray in the treatment of morphine intolerant patients with advanced cancer in terms of analgesic efficacy， reducing pain level， improving life quality and reducing the incidence of adverse reactions.