Injection of dexmedetomidine into epidural space in assistance of labor analgesia

Abstract

Objective To analyze the clinical effect of the injection of dexmedetomidine into epidural space in the assistance of labor analgesia and the parturients' hemodynamic status and its influence on the neonates. Methods A total of 150 parturients having delivery from January to June, 2017 were randomly divided into an RD group (ropivacaine combined with dexmedetomidine ) and an RT group (ropivacaine combined with tramadol). The status of sensory nerve block, the time of labor process, the bleeding volume after delivery, and the untoward responses during labor analgesia were recorded. The mean arterial pressure(MAP) and heat rate(HR) and the score of visual analogue scale (VAS) were recorded when the dilation of cervix got to 3(T1), 5(T2), 7(T3), and 10 cm (T4). The blood samples were drawn from umbilical vein for gas analysis and the newborn Apgar scores at 1 and 5 minutes were also recorded after delivery. Results The onset time of nerve block and the time to maximum sensory nerve analgesic level [(6.380±1.008) min vs.(7.880±1.409) min and (11.540±1.439)min vs.﹙13.040±1.748) min, both P<0.05] were shorter and the maximum sensory nerve analgesic level (P<0.05) was higher in the RD group than in the RT group. The MAP at T1, T2, and T3 were significantly lower in the RD group than in the RT group, with statistical differences (all P<0.01). The HR and VAS at T1, T2, T3, and T4 were lower in the RD group than in the RT group, with statistical differences (all P<0.05). The incidences of nausea, vomiting, and shiver were significantly lower in the RD group than in the RT group (2.6% vs. 9.3%, 0.0% vs. 4.0%, and 2.6% vs. 8.0%, all P<0.01), but the incidence of sinus bradycardia was higher in the RD group than in the RT group (5.3% vs. 2.6%, P<0.05). The heart rates of all the parturient' during delivery were more than 50 beats per minute. Conclusions Ropivacaine combined with dexmedetomidine injected into the epidural space for labor analgesia can provide better abirritation and is superior to ropivacaine combined with tramadol, so it is more suitable for labor analgesia. Key words: Dexmedetomidine; Tramadol; Labor analgesia; Epidural anesthesia