Clinical Study Of Continuous Epidural Analgesia Of Dexmedetomidine Combined With Ropivacaine On Labor Analgesia

Objective: To study the effects of dexmedetomidine combined with ropivacaine for continuous epidural labor analgesia on the analgesic effect,maternal and infant situation,and postpartum low back pain.Methods:210 full-term primiparas who planned vaginal delivery were selected and divided into three groups: voluntary no labor analgesia group(C group,n=70),all subjects who voluntarily did not perform labor analgesia were divided into two groups by random number table method: 0.1% ropivacaine for continuous epidural labor analgesia group(R group,n=70)and 0.1% ropivacaine combined with 0.5ug/ml dexmedetomidine for continuous epidural labor analgesia group(RD group,n=70).MAP,HR,Sp O2,Ramsay sedation score at different time points were observed.Analgesic effect index,consumption of ropivacaine,adverse reactions,number of contractions,duration of labor,and Apgar score of the newborn were recorded.Umbilical artery blood gas index and the concentration of catecholamines in umbilical venous blood were recorded.And follow-up of the three groups of puerpera 2 days,42 days,and 6 months of low back pain.Results:There were no significant differences in general condition,the number of uterine contractions,duration of labor,Sp O2,and incidence of postpartum low back pain among the three groups(P>0.05),and no significant differences in neonatal Apgar score and umbilical artery blood p H(P>0.05).Compared with C and R groups,MAP and HR in the RD group tended to be stable(P<0.05),significantly decreased umbilical artery blood lactate and the concentration of maternal catecholamines(P<0.05),significantly decreased the NRS score of uterine pain(P<0.05),kept awake,and significantly decreased the incidence of shivering(P<0.05).Compared with the R group,the onset time of analgesia in the RD group was shorter,the maintenance time was longer,and the consumption of ropivacaine was reduced(P<0.05).Conclusion:Dexmedetomidine combined with ropivacaine for continuous epidural labor analgesia can enhance the analgesic effect of ropivacaine,reduce the dosage of ropivacaine,reduce the incidence of maternal chills,and reduce catecholamines in umbilical cord blood,did not affect the number of contractions,labor duration and the incidence of postpartum low back pain,the parturient hemodynamics was stable,and there were no obvious adverse effects on Apgar score,p H value and lactic acid value of the newborn.