Delavari Abasali, Dehgan Mahdi, Lak Marzieh
Trauma research center, Baqiyatallah University of Medical Sciences, Tehran, Iran.
Rom J Anaesth Intensive Care. 2022 Sep 25;28(1):10-18. doi: 10.2478/rjaic-2021-0002. eCollection 2021 Jul.
The pain of labour is very severe. Most women prefer painless labour to routine labour if they are aware of the methods of analgesia. The aim of this study was to evaluate the effect of dexmedetomidine intravenous infusion on labour pain management in primipara term pregnant women.
In this nonrandomised clinical trial with control group, all primipara term pregnant women from August 2019 to March 2020 were included. In the intervention group, after the active phase of labour, dexmedetomidine was given according to the protocol and continued until phase 2 of labour. The control group received no intervention to reduce pain. Patients in both groups were evaluated for fetal heart rate, Apgar scores, vital signs, pain intensity, and sedation score.
There were no significant differences in primary fetal heart rate, primary maternal hemodynamics, and mean Apgar scores at 1 and 5 minutes between the two groups (p > .05). There was no significant difference in the mean fetal heart rate in different stages between the two groups. Intragroup analysis in the intervention group showed that mean systolic and diastolic blood pressures were significantly decreased after drug administration but were in the normal range. The active phase of labour in the intervention group was significantly shorter than in the control group (p = 0.002). The mean Visual Analogue Scale (VAS) score after dexmedetomidine administration decreased significantly from 9.25 at baseline to 4.61 after drug administration, 3.88 during labour, and 1.88 after placental expulsion. The mean Ramsay Sedation Scale score after dexmedetomidine administration increased significantly from 1.00 at baseline to 2.05 after drug administration, 2.22 during labour, and 2.05 after placental expulsion.
Based on the study's results, the administration of dexmedetomidine to manage labour pain with careful monitoring of mother and fetus is recommended.
分娩疼痛非常剧烈。如果大多数女性了解镇痛方法,她们更倾向于无痛分娩而非常规分娩。本研究的目的是评估右美托咪定静脉输注对初产妇足月妊娠分娩疼痛管理的效果。
在这项有对照组的非随机临床试验中,纳入了2019年8月至2020年3月期间所有的初产妇足月孕妇。在干预组中,分娩活跃期后,按照方案给予右美托咪定,并持续至第二产程。对照组未接受减轻疼痛的干预措施。对两组患者的胎儿心率、阿氏评分、生命体征、疼痛强度和镇静评分进行评估。
两组之间的初始胎儿心率、初始产妇血流动力学以及1分钟和5分钟时的平均阿氏评分均无显著差异(p>0.05)。两组不同阶段的平均胎儿心率无显著差异。干预组的组内分析显示,给药后平均收缩压和舒张压显著降低,但仍在正常范围内。干预组的分娩活跃期明显短于对照组(p = 0.002)。右美托咪定给药后的平均视觉模拟评分(VAS)从基线时的9.25显著降低至给药后4.61、分娩期间3.88以及胎盘娩出后1.88。右美托咪定给药后的平均拉姆齐镇静评分从基线时的1.00显著增加至给药后2.05、分娩期间2.22以及胎盘娩出后2.05。
基于研究结果,建议在密切监测母婴的情况下给予右美托咪定以管理分娩疼痛。