Effect of Epidural Dexmedetomidine vs Nalbuphine for Labor Analgesia:#xd;A randomized clinical trial

Abstract

ABSTRACT Background The addition of dexmedetomidine or nalbuphine to epidural bupivacaine was tested to decrease labor pain in women undergoing normal delivery. Patients and Methods Sixty-four patients were randomly allocated into 2 groups of 32 parturients, each with consent from the parturient. Groups A and B received a bolus of 12 ml volume consisting of 11 ml of 0.25% bupivacaine and 0.5 μg/ml dexmedetomidine (1 ml volume) through the epidural catheter, then a top-up dose of 6 ml volume consisting of 5 ml of 0.25% bupivacaine and 0.5 μg/ml dexmedetomidine (1 ml volume) was given when the VAS score becomes 4 or more, and a bolus of 12 ml volume consisting of 11 ml of 0.25% bupivacaine and 10 mg nalbuphine (1 ml volume) through the epidural and a top-up dose of 5 ml of 0.25% bupivacaine and 2 mg nalbuphine (1 ml volume) were given, respectively. Assessments included the VAS score, vital data monitoring, duration of stages of labor, APGAR score, and adverse effects. Results Both groups had satisfactory labor analgesia, but those in the dexmedetomidine group had lower pain scores than those in the nalbuphine group, because dexmedetomidine had a faster onset than nalbuphine. Conclusion Epidural dexmedetomidine seems to offer some advantages over epidural nalbuphine. Thus, it can be used safely as an adjuvant to epidural bupivacaine in labor analgesia.