Department of Anesthesiology, Baotou Obstetrics and Gynecology Hospital, Inner Mongolia (the Third Hospital of Inner Mongolia Baotou Iron and Steel Group), Gaotou 014010, China.
Department of Neonatal Pediatrics, Baotou Obstetrics and Gynecology Hospital, Inner Mongolia (the Third Hospital of Inner Mongolia Baotou Iron and Steel Group), Gaotou 014010, China.
J Healthc Eng. 2022 Mar 29;2022:2235025. doi: 10.1155/2022/2235025. eCollection 2022.
Side effects of the use of opioid analgesics during painless delivery are the main factors that affect rapid postpartum recovery. Opioid use can result in dangerous respiratory depression in the patient. Opioids can also disrupt the baby's breathing and heart rate. The nonopioid analgesic dexmedetomidine, a new a2-adrenergic agonist, possesses higher selectivity, greater analgesic effects, and fewer side effects. Moreover, epidural administration of dexmedetomidine also reduces local anesthetic consumption.
Our study aims to compare the analgesic effects as well as the side effects of ropivacaine with dexmedetomidine against sufentanyl as an epidural labor analgesia.
This study is a randomized, double-blinded, controlled trial (registration no. ChiCTR2200055360) involving 120 primiparous (a woman who has given birth once), singleton pregnancy women who are greater than 38 weeks into gestation and have requested epidural labor analgesia. The participants were randomized to receive 0.1% ropivacaine with sufentanyl (0.4 g/ml) or dexmedetomidine (0.4 g/ml). The primary outcomes included Visual Analogue Score (VAS), duration of first epidural infusions, the requirement of additional PCEA bolus, and adverse reactions during labor analgesia.
Of the 120 subjects who consented, 91 parturient women (women in the condition of labor) had complete data for analysis. Demographics and VAS, as well as maternal and fetal outcomes, were similar between the groups. The duration of first epidural infusions in dexmedetomidine was significantly longer than sufentanyl (median value: 115 vs 68 min, < 0.01); the parturient women who received dexmedetomidine and who required additional PCEA bolus were fewer in comparison to those who received sufentanyl (27.5% vs 49.0%, < 0.05). Furthermore, the incidence of pruritus in the dexmedetomidine group was lower in comparison to the sufentanyl group (0% vs 11.8%, < 0.05).
Dexmedetomidine, a nonopioid, is superior to the opioid analgesic sufentanyl in providing a prolonged analgesic effect as an epidural during labor. It also reduces local anesthetic consumption and has fewer side effects. The trial is registered with ChiCTR2200055360.
无痛分娩中使用阿片类镇痛药的副作用是影响产后快速恢复的主要因素。阿片类药物会导致患者出现危险的呼吸抑制。阿片类药物还会干扰婴儿的呼吸和心率。新型 a2-肾上腺素能激动剂右美托咪定是非阿片类镇痛药，具有更高的选择性、更强的镇痛效果和更少的副作用。此外，硬膜外给予右美托咪定还可以减少局部麻醉药的消耗。
本研究旨在比较罗哌卡因联合右美托咪定与舒芬太尼用于硬膜外分娩镇痛的镇痛效果和副作用。
这是一项随机、双盲、对照试验（注册号：ChiCTR2200055360），纳入了 120 名初产妇（曾分娩过一次的妇女）、单胎妊娠、孕周大于 38 周并要求硬膜外分娩镇痛的孕妇。参与者被随机分为接受 0.1%罗哌卡因联合舒芬太尼（0.4μg/ml）或右美托咪定（0.4μg/ml）。主要结局包括视觉模拟评分（VAS）、首次硬膜外输注持续时间、需要额外的 PCEA 推注以及分娩镇痛期间的不良反应。
在 120 名同意的受试者中，91 名产妇（处于分娩状态的妇女）有完整的数据进行分析。两组的人口统计学特征、VAS 以及母婴结局相似。右美托咪定的首次硬膜外输注持续时间明显长于舒芬太尼（中位数：115 比 68min， < 0.01）；需要额外 PCEA 推注的产妇中，接受右美托咪定的比例明显低于接受舒芬太尼的产妇（27.5%比 49.0%， < 0.05）。此外，右美托咪定组瘙痒的发生率明显低于舒芬太尼组（0%比 11.8%， < 0.05）。
非阿片类药物右美托咪定在硬膜外分娩镇痛中提供延长的镇痛效果方面优于阿片类镇痛药舒芬太尼。它还减少了局部麻醉药的消耗，并且副作用更少。该试验已在 ChiCTR2200055360 注册。
