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Nalbuphine-assisted delayed epidural analgesia significantly shortens first-stage labor duration in first-time mothers without increasing maternal complications.
For women experiencing childbirth for the first time, nalbuphine-assisted delayed epidural analgesia may offer the dual benefit of effective pain management and a shorter first stage of labor, according to the findings of a new study.
Researchers conducted this randomized trial to determine the effect of nalbuphine-facilitated delayed epidural analgesia on the duration of first-stage labor. They enrolled 120 nulliparous women for the final statistical evaluation. Participants were randomly assigned to either an early epidural analgesia group receiving normal saline (NS group) or a delayed epidural analgesia group receiving nalbuphine as a bridging analgesic (NB group).
The key endpoint assessed the first-stage labor duration. Additional maternal and obstetric outcomes included postpartum hemorrhage, oxytocin use, vomiting, labor induction methods, episiotomy rate, contamination of amniotic fluid, maternal fever, nausea, and cesarean delivery incidence. Kaplan–Meier survival curve analysis was executed to compare labor duration between groups. The NB group experienced a significantly shorter first stage of labor compared with the NS group.
Survival analysis demonstrated a higher likelihood of faster labor progression in the nalbuphine group (hazard ratio = 1.629; P < 0.05). No statistically significant differences were identified between groups in postpartum hemorrhage, oxytocin administration, induction techniques, episiotomy frequency, amniotic fluid contamination, maternal pyrexia, nausea, vomiting, or cesarean section rates, indicating comparable maternal safety profiles.
The findings suggest that, for nulliparous females, using nalbuphine as a bridge to delayed epidural analgesia may reduce the duration of the first stage of labor vs. early epidural analgesia initiated at cervical dilation of 3 cm or less, without increasing adverse maternal or delivery-related outcomes.
Drug Design, Development and Therapy
Nalbuphine as a Bridge to Delayed Epidural Analgesia: A Randomized Trial on First-Stage Labor Duration
Yang Xu et al.
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