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The
right concentration of epidural dexmedetomidine in combination with 0.1%
ropivacaine for parturient women in epidural labor analgesia
was found to be 0.5 µg/mL.
Epidural labor analgesia is the common technique used for the management of labor pain. Ropivacaine has been often used for epidural labor analgesia, because of less motor block and stable hemodynamics. Dexmedetomidine possess sedative and analgesic properties without causing respiratory depressant effect and enhances local anaesthetic effects without increasing the incidence of side effects.
Combining Dexmedetomidine with local anesthetics might decrease the
concentration of epidural ropivacaine. However, the optimal dose of epidural
dexmedetomidine to combine with ropivacaine for providing labor analgesia is
still not clear.
The main objective of this study was to determine the effect of adding
different dose of epidural dexmedetomidine to ropivacaine during epidural labor
analgesia.
This was prospective, single-blinded designed study. For this 100 parturient
women were enrolled. They were assigned randomly to one of the four groups
(Groups A, B, C, and D which received 0.25, 0.5, 0.75, and 1 μg/ml of
dexmedetomidine plus 0.1% ropivacaine, resp.). The onset of epidural anesthesia
and stages of labor were noted. Assessment of pain was done using a visual
analogue scale (VAS). Vitals like Hemodynamic parameters and fetal heart rate
were also monitored. Apgar scores and umbilical artery pH were recorded. In
case any side effects appeared were also recorded.
The results evaluated that addition of 0.25, 0.5, and 0.75 μg/ml of
dexmedetomidine to 0.1% ropivacaine showed safe and effective analgesia. But adding
1 μg/ml of dexmedetomidine resulted in increased incidence of motor block. The
hemodynamic parameters were found similar between the groups. In Group D side
effects were noted to be significantly higher than in other three groups.
So the study concludes that the optimal concentration of dexmedetomidine to
combine with with 0.1% ropivacaine for providing epidural labor analgesia is
0.5 μg/ml.
Evidence-based Complementary and Alternative Medicine
Optimal Dose of Epidural Dexmedetomidine Added to Ropivacaine for Epidural Labor Analgesia: A Pilot Study
Zhang Wangping, Ren Ming
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