Opioid-Free Labor Analgesia: Dexmedetomidine as an Adjuvant Combined with Ropivacaine

• Published in: Journal of healthcare engineering 2022-03, Vol.2022, p.2235025-7
• Main Authors: Gao, Wei, Wang, Jie, Zhang, Zhiguo, He, Haiying, Li, Huiwen, Hou, Ruili, Zhao, Liping, Gaichu, Daniel Muthee
• Format: Article
• Language: English
• Subjects: Analgesia, Obstetrical - adverse effects; Analgesics - adverse effects; Analgesics, Opioid - therapeutic use; Anesthetics, Local - adverse effects; Anesthetics, Local - therapeutic use; Dexmedetomidine - adverse effects; Dexmedetomidine - therapeutic use; Female; Humans; Pregnancy; Ropivacaine - adverse effects; Ropivacaine - therapeutic use; Sufentanil
• ISSN: 2040-2295; 2040-2309
• DOI: 10.1155/2022/2235025

Background. 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. Objective. 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. Methods. 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 μg/ml) or dexmedetomidine (0.4 μg/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. Results. 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, P