Ali Hassan Mohamed, Wahdan Amr
Department of Anesthesia, Faculty of Medicine, Cairo University, Cairo, Egypt.
Saudi J Anaesth. 2018 Apr-Jun;12(2):209-214. doi: 10.4103/sja.SJA_435_17.
This is a randomized controlled trial aiming at comparing the effectiveness of levobupivacaine alone versus a levobupivacaine with dexamethasone in the epidural injection for painless labor.
This is a comparative randomized controlled double-blinded clinical trial with 49 patients were included in this study, all of them were primigravidas and were during vaginal delivery with a cervical dilatation ≥4 cm. Patients were included randomly in one of two groups either Group C (26 cases) with epidural levobupivacaine 0.125% in normal saline or Group D (23 cases) with epidural levobupivacaine 0.125% in normal saline combined with dexamethasone 8 mg. The duration of a second dose request, total dose given, neonatal outcome and adverse effects of epidural were recorded.
Group D showed a longer duration of analgesia than Group C (80.5 ± 12.39 min in Group D vs. 61.75 ± 10.74 min in Group C) with a < 0.05 (0.001). Furthermore, the patients in Group D received smaller dose of levobupivacaine than those in Group C with a statistically significant difference (90.87 ± 33.42 vs. 127.21 ± 40.68 mg with = 0.002). There were no statistical differences between the two groups regarding hemodynamics, pain score, neonatal outcome, and complications.
Dexamethasone in epidural analgesia for painless labor has a prolonged duration of analgesia with no complications for both the mother and the infant.
本研究为一项随机对照试验，旨在比较单纯左旋布比卡因与左旋布比卡因联合地塞米松用于硬膜外注射分娩镇痛的效果。
这是一项比较性随机对照双盲临床试验，本研究纳入49例患者，均为初产妇，处于宫颈扩张≥4 cm的阴道分娩期。患者被随机分为两组，C组（26例）硬膜外注射0.125%左旋布比卡因生理盐水溶液，D组（23例）硬膜外注射0.125%左旋布比卡因生理盐水溶液联合8 mg地塞米松。记录第二次给药请求的持续时间、给药总量、新生儿结局及硬膜外的不良反应。
D组镇痛持续时间长于C组（D组为80.5±12.39分钟，C组为61.75±10.74分钟），P<0.05（0.001）。此外，D组患者接受的左旋布比卡因剂量小于C组，差异有统计学意义（分别为90.87±33.42 mg和127.21±40.68 mg，P=0.002）。两组在血流动力学、疼痛评分、新生儿结局及并发症方面无统计学差异。
地塞米松用于分娩镇痛硬膜外麻醉时，可延长镇痛持续时间，对母婴均无并发症。
