Comparative Study Of Sufentanil,Dexmedetomidine And Ropivacaine In Epidural Labor Analgesia

Objective:The addition of sufentanil or dexmedetomidine to local anesthetics in patients receiving epidural labor analgesia has been safely used in clinical work.In this study,a randomized,double-blind method was used to compare the effects of the two adjuvants on labor analgesia.Methods:160 primiparas were included in the study and randomly divided into four groups.Group R(n = 40)received only 0.08% ropivacaine;RD group(n = 40)received 0.08%ropivacaine+0.5μɡ/ ml dexmedetomidine;RS group(n = 40)received 0.08% ropivacaine+0.5μɡ/ ml sufentanil;RDS group(n = 40)received 0.08% ropivacaine+0.25μɡ/ml dexmedetomidine+0.25μɡ/ml sufentanil.Patients received 3ml lidocaine test dose and10 ml local anesthetic in corresponding grouping as load dose,and then maintained through patient-controlled epidural analgesia pump.The collected data include systolic blood pressue(SBP),diastolic blood pressure(DBP)and heart rate(HR)before administration(T0),10 minutes after administration(T1),during delivery(T2),2 hours after delivery(T3),visual analogue scale score onset time,Ramsay sedation score,Bromage score time of each labor process total amount of local anesthetics,Patient controlled administration times,umbilical artery blood(p H,PO2,p CO2),Apgar score after delivery,adverse reactions and blood loss.Results:At T1,SBP and DBP of RS group were significantly lower than those of RDS group and RD group.At T2 and T3,SBP and DBP of RD group were significantly lower than those of RDS group and RS group.At T1 and T2,there was no significant difference in heart rate among RS group,RD group and RDS group.At T3,the heart rate of RD group was significantly lower than that of RDS group and RS group.The VAS score of RDS group was lower at different time points.The onset time of RDS group was significantly faster than that of the other three groups.The total amount of medication and the number of self-control administration in RDS group and RD group were less than those in RS group and R group.The incidence of postoperative pruritus in RS group was significantly higher than that in R group,RD group and RDS group.Conclusion:The addition of epidural adjuvant can significantly improve the effect of labor analgesia.Compared with adding 0.5μɡ/ml sufentanil or 0.5μg/ml dexmedetomidine,0.25μg/ml dexmedetomidine+0.25μg/ml sufentanil combined with 0.08% ropivacaine has better analgesic effect,more stable hemodynamics and lower adverse reactions.