Addition of Optimal Dose of Epidural Dexmedetomidine to Ropivacaine for Epidural Labor Analgesia

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Addition of Optimal Dose of Epidural Dexmedetomidine to Ropivacaine for Epidural Labor Analgesia

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.

Source:

Evidence-based Complementary and Alternative Medicine

Link to the source:

https://www.hindawi.com/journals/ecam/2017/7924148/

Original title of article:

Optimal Dose of Epidural Dexmedetomidine Added to Ropivacaine for Epidural Labor Analgesia: A Pilot Study

Authors

Zhang Wangping and Ren Ming

SearchTags: 
Therapeutic, Dexmedetomidine, ropivacaine, labour pain, Sedative, local anesthesia, prospective, single-blinded study, efficacy, safety, VAS, motor block (in case of high dose)
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