Dexmedetomidine versus sufentanil with high- or low-concentration ropivacaine for labor epidural analgesia: A randomized trial.

AIM

To study analgesic effects of dexmedetomidine or sufentanil, both combined with ropivacaine, in epidural analgesia during labor.

METHODS

We recruited 160 primigravidae with full-term pregnancy who received epidural anesthesia during labor and randomized them into four groups to receive epidural administration of ropivacaine combined with sufentanil (RS and RS groups) or with dexmedetomidine (RD and RD groups). Systolic blood pressure, diastolic blood pressure and heart rate before anesthesia (T ), 15 min after anesthesia induction (T ), on delivery (T ) and 2 h postpartum (T ), together with visual analogue scale scores, Bromage scores, Ramsay scores, adverse reactions during analgesia and urinary retention at 6 and 24 h postpartum were recorded; the pH, PCO and PO of umbilical cord arterial blood and Apgar scores at 1, 5 and 10 min after childbirth were assessed.

RESULTS

RS group had significantly lower systolic blood pressure, diastolic blood pressure and heart rate than RD group at T and T (all P < 0.05), but not at T1. At T and T , the other three groups were lower than RS group in visual analogue scale and Ramsay scores (all P < 0.05). After childbirth, RD group had significantly higher PO result than other three groups (P < 0.05). At 6 h postpartum, RD group had significantly fewer cases of urinary retention than RD and RS groups (both P < 0.05).

CONCLUSION

A relatively low concentration of ropivacaine, combined with dexmedetomidine, is better in analgesia during labor.