Mashak Banafsheh, Ataee Mina, Hashemnejad Maryam, Bagheri Ramesh Baradaran, Esmi Mona, Farahani Masoumeh, Masoomzadeh Maedeh
Department of Anesthesiology, School of Medicine, Kamali Hospital, Alborz University of Medical Sciences, Karaj, Iran.
Department of Obstetrics and Gynecology, School of Medicine, Kamali Hospital, Alborz University of Medical Sciences, Karaj, Iran.
Ann Med Surg (Lond). 2025 May 20;87(7):4110-4116. doi: 10.1097/MS9.0000000000003405. eCollection 2025 Jul.
The purpose of this study was to evaluate the effect of adding low-dose bupivacaine-dexamethasone for intrathecal labor analgesia in vaginal delivery.
This study was conducted as a clinical trial on full-term, singleton pregnant women aged between 20 and 40 years, who were candidates for natural childbirth and were in the second phase of the first stage of labor. Patients were randomly assigned to either the control group, which received only a single-shot intrathecal injection of 5 μg of sufentanil, or the intervention group, which, in addition to receiving spinal anesthesia with a single-shot intrathecal injection of 5 μg of sufentanil, also received an intrathecal injection of 5 mg of dexamethasone. The variables examined included the duration of maternal pain relief during the natural childbirth process, the time of the first request for additional pain relief by the mother during the natural childbirth process, maternal vital signs, and the arterial blood gas (ABG) of the newborn at birth, comparing the two groups.
The average duration of analgesia was 237.67 ± 53.46 minutes in the case group, which was significantly higher than the average analgesia time in the control group with 149.57 ± 68.82 ( < 0.001). Also, the average time of request to repeat analgesia was 235.33 ± 47.41 in the case group, which was longer than the control group with 140.78 ± 90.90 ( < 0.001). In general, the course of labor in the case group was 288.00 ± 45.45 minutes shorter than the control group by 375.00 ± 181.12 minutes ( = 0.019).
The simultaneous addition of dexamethasone to sufentanil during natural childbirth can increase the time of analgesia and the time of request to repeat analgesia and decrease the duration of labor. The simultaneous use of dexamethasone and sufentanil is recommended in comparison with sufentanil alone due to its safety for the mother and child and the creation of more favorable analgesia during vaginal childbirth.
本研究旨在评估鞘内注射低剂量布比卡因 - 地塞米松用于阴道分娩时分娩镇痛的效果。
本研究作为一项临床试验，针对年龄在20至40岁之间、单胎足月、适合自然分娩且处于第一产程第二阶段的孕妇开展。患者被随机分为对照组和干预组，对照组仅接受单次鞘内注射5μg舒芬太尼，干预组除接受单次鞘内注射5μg舒芬太尼进行脊髓麻醉外，还接受鞘内注射5mg地塞米松。所检测的变量包括自然分娩过程中产妇疼痛缓解的持续时间、自然分娩过程中母亲首次要求追加镇痛的时间、产妇生命体征以及新生儿出生时的动脉血气（ABG），对两组进行比较。
病例组的平均镇痛持续时间为237.67±53.46分钟，显著高于对照组的平均镇痛时间149.57±68.82分钟（<0.001）。此外，病例组要求重复镇痛的平均时间为235.33±47.41分钟，长于对照组的140.78±90.90分钟（<0.001）。总体而言，病例组的产程比对照组短288.00±45.45分钟，对照组为375.00±181.12分钟（P = 0.019）。
自然分娩时在舒芬太尼中同时添加地塞米松可延长镇痛时间和要求重复镇痛的时间，并缩短产程。与单独使用舒芬太尼相比，建议同时使用地塞米松和舒芬太尼，因为其对母婴安全，且在阴道分娩时能产生更有利的镇痛效果。
