Effectiveness of dexmedetomidine in patient-controlled epidural analgesia during labor

Objective To evaluate the effectiveness of dexmedetomidine combined with ropivacaine in patient-controlled epidural analgesia(PCEA) during labor. Methods A total of 60 parturient women were selected and randomly divided into two groups(n = 30): a control group(group R) and a study group(group RD). Both groups underwent epidural labor analgesia,in which group R received 10 ml of 0. 125% ropivacaine and group RD received 10 ml of 0. 125% ropivacaine + 0. 5 mg/L dexmedetomidine as the first dose. After 30 min,a PCEA pump was connected via the epidural catheter,where the PCEA solution was 0. 1% ropivacaine and 0.1% ropivacaine + 0.5 mg/L dexmedetomidine respectively. Then,their heart rate(HR),mean arterial pressure(MAP) and oxygen saturation(Sp O₂) was recorded before labor analgesia(T0),10 min after analgesia(T1),30 min after analgesia(T2),60 min after analgesia(T3),at full cervical dilation (T4),and immediately after delivery(T5). The VAS score were evaluated at T0-T5,Ramsay sedation score was recorded at T2-T5,and modified Bromage score was recorded at T1-T5. The level of anesthesia,PCEA dosage and times were observed. The time of labor,Apgar score,and incidence of complications were recorded. Results Compared with group R,group RD presented remarkable decreases in HR at T2 and T3,and in MAP at T3（P ＜ 0. 05). Group RD produced significantly higher Ramsay sedation score than group R（P ＜ 0. 05). Compared with group R,remarkable decreases were found in PCEA dosage and times and the incidence of shiver in group RD（P ＜0. 05). There was no significant difference in VAS score,modified Bromage score,the level of anesthesia,the time of labor,Apgar score,and the incidence of other complications between the two groups（P ＞ 0. 05). Conclusions The combined use of dexmedetomidine and ropivacaine can improve the sedative effect of PCEA during labor,reduce the dosage and the incidence of shiver,without significant effect on labor time and newborn.