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Dexmedetomidine versus sufentanil with high‐ or low‐concentration ropivacaine for labor epidural analgesia: A randomized trial
Author(s) -
Cheng Qiuju,
Bi Xiaobao,
Zhang Weiqiang,
Lu Yanling,
Tian Hang
Publication year - 2019
Publication title -
journal of obstetrics and gynaecology research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.597
H-Index - 50
eISSN - 1447-0756
pISSN - 1341-8076
DOI - 10.1111/jog.14104
Subject(s) - medicine , sufentanil , dexmedetomidine , ropivacaine , anesthesia , blood pressure , visual analogue scale , heart rate , urinary retention , randomized controlled trial , bradycardia , sedation , surgery
Aim To study analgesic effects of dexmedetomidine or sufentanil, both combined with ropivacaine, in epidural analgesia during labor. Methods We recruited 160 primigravidae with full‐term pregnancy who received epidural anesthesia during labor and randomized them into four groups to receive epidural administration of ropivacaine combined with sufentanil (RS 1 and RS 2 groups) or with dexmedetomidine (RD 1 and RD 2 groups). Systolic blood pressure, diastolic blood pressure and heart rate before anesthesia (T 1 ), 15 min after anesthesia induction (T 2 ), on delivery (T 3 ) and 2 h postpartum (T 4 ), together with visual analogue scale scores, Bromage scores, Ramsay scores, adverse reactions during analgesia and urinary retention at 6 and 24 h postpartum were recorded; the pH, PCO 2 and PO 2 of umbilical cord arterial blood and Apgar scores at 1, 5 and 10 min after childbirth were assessed. Results RS 1 group had significantly lower systolic blood pressure, diastolic blood pressure and heart rate than RD 1 group at T 2 and T 3 (all P < 0.05), but not at T1. At T 2 and T 3 , the other three groups were lower than RS 2 group in visual analogue scale and Ramsay scores (all P < 0.05). After childbirth, RD 2 group had significantly higher PO 2 result than other three groups ( P < 0.05). At 6 h postpartum, RD 2 group had significantly fewer cases of urinary retention than RD 1 and RS 1 groups (both P < 0.05). Conclusion A relatively low concentration of ropivacaine, combined with dexmedetomidine, is better in analgesia during labor.