Clinical Study Of Dexmedetomidine On Labor Pain And Anxiety During Maternal Delivery

Objective:To investigate the effects of dexmedetomidine on labor pain and anxiety when used for epidural labor analgesiaand,serving as a reference of clinical anesthesia.Methods : 180 cases of parturient women of primiparity were selected and divided into test group and control group on the basis of the sequence of treatment.1ug/ml dexmedetomidine and 0.1% ropivacaine were provided for epidural analgesia of test group,while 1ug/ml fentanyl and 0.1% ropivacaine were provided for epidural analgesia of control group.The observation time points were: as cervix opened about 3cm before labor analgesia(T0),cervix opened about 8cm at the end of the first stage of labor after epidural analgesia(T1).The Ramsay sedation score,Ramsay sedation score,Epinephrine,Noradrenaline,Visual Analogue Scale,VAS,Heart Rate,HR and ststolic blood pressure,SBP were measured and recorded in two time points.And the stage of labor,cesarean section rate and adverse reaction of mothers were recorded.Results:(1)The comparison of basic information between two mothers in two groups.There was no statistical difference between basic information of two groups(P>0.05).(2)Comparison of degree of antianxiety between two groups before and after analgesia: at T0,the difference in anxiety of mothers had no statistical significance between test group and control group(2?=0.105,P=0.949).At T1,the score ofmothers' anxiety in test group decreased more than control group,the difference was statistically significant(2?=8.94,P=0.01).The Ramsay sedation score of mothers in two groups increased at T1,and that of mothers in test group increased 1.25 ± 0.74,which was higher than control group(0.71±0.57),and the difference was statistically significant(t matched=5.53,P=0.000).At T1,the blood E and NE levels of mothers in both groups decreased,and the blood E level of test group(1.74±0.57ng/ml)decreased more than that of control group(0.75±0.35 ng/ml),and the difference had statistical significance(t matched ==17.50,P=0.000).Blood NE level of test group(0.26 ± 0.07 ng/ml)decreased more than control group(0.17 ± 0.07ng/ml),and the difference was statistically significant(t matched==8.79,P=0.000).(3)Comparison of analgesia effects of two groups of mothers after labor analgesia: VAS scores of mothers in both groups decreased to some extent,and test group(4.94±1.03)decreased more than control group(3.76±1.17),and the difference had statistical significance(t matched=7.22,P=0.000).(4)Comparison of clinical effects of labor analgesia: the period of the second stage of labor of mothers in test group was(66±13min),which was shorter than labor time of control group(82±14 min),and the difference was statistically significant(P<0.05).The cesarean section rate of mothers in test group and control group was 5.6% and 13.92% respectively,and there was no statistical significance in difference of cesarean section rates(2? =2.47,P=0.12).HR and SBP of mothers in both groups decreased to someextent,and HR of mothers in test group decreased 12.17±6.86 times/min,while that of control group decreased 12.29 ± 6.89 times/min,and the difference had no statistical significance(t matched= 0.295,P=0.768).SBP of mothers in test group decreased 6.82±3.70 mmHg,and that in control group decreased 7.00±4.31 mmHg,and the difference had no statistical significance(t matched=0.587,P=0.907).Apgar's scores of babies in both groups were higher than 8,having no statistical difference.9 cases of nausea and vomit were found in control group,while no related adverse reaction was found in test group.There was a statistical significance in the incidence rate difference between mothers in two groups.Conclusion: Adopting dexmedetomidine in epidural labor analgesiaand can effectively reduce the pain and anxiety;Reduce excessive stress during maternal birth,have no adverse effects on baby and mother;Improve the satisfaction of delivery analgesia and make a good foundation for the quality of delivery.