Epidural Dexmedetomidine for Prevention of Intrapartum Fever During Labor Analgesia: A Randomized Controlled Trial
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ORIGINAL RESEARCH
Epidural Dexmedetomidine for Prevention of Intrapartum Fever During Labor Analgesia: A Randomized Controlled Trial Li Li . Zeyong Yang . Wangping Zhang
Received: August 11, 2020 / Accepted: October 28, 2020 Ó The Author(s) 2020
ABSTRACT Introduction: Intrapartum fever occurs frequently during labor. The purpose of this study was to investigate the effects of epidural dexmedetomidine on maternal temperature, pain score and adverse effects during labor analgesia. Methods: A total of 600 full-term primiparous parturients were randomly divided into two groups. The dexmedetomidine group (Group Dex, n = 300) received 0.1% ropivacaine with 0.5 lg/mL dexmedetomidine for epidural analgesia during labor, while the control group (Group C, n = 300) received 0.1% ropivacaine alone. The maternal temperature, visual analogue scale (VAS) and Ramsay sedation score (RSS) were recorded, and the systolic blood Li Li and Yang Zeyong contributed equally to this article. L. Li Department of Anesthesiology, Wenzhou Central Hospital, Wenzhou 325000, China Z. Yang Department of Anesthesiology, International Peace Maternity and Child Health Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200030, China W. Zhang (&) Department of Anesthesiology, Women and Children’s Hospital of Jiaxing University, Jiaxing 314000, China e-mail: [email protected]
pressure (SBP), diastolic blood pressure (DBP) and heart rate (HR) were monitored. Side effects, if any, were also recorded. Results: The incidence of intrapartum fever was lower in Group Dex than in Group C (4.1% vs. 8.7%, v2 = 5.07, P = 0.024). VAS values from the time of 3 cm cervical dilatation to 10 cm cervical dilatation were also lower in Group Dex than in Group C (1.0 ± 0.9 vs. 1.3 ± 0.7, t = 3.62, P \ 0.001; 2.8 ± 0.8 vs. 3.3 ± 0.8, t = 8.09, P \ 0.001; 3.1 ± 0.9 vs. 3.3 ± 0.8, t = 3.88, P \ 0.001; 3.6 ± 0.8 vs. 4.1 ± 1.0, t = 5.86, P \ 0.001, respectively). HR from the time of 3 cm cervical dilatation to 10 cm cervical dilatation was lower during labor in Group Dex than in Group C (80.0 ± 4.3 vs. 83.1 ± 5.4 beats/min, t = 7.58, P \ 0.001; 81.1 ± 4.0 vs. 83.7 ± 5.5 beats/min, t = 6.48, P \ 0.001; 78.9 ± 5.4 vs. 81.5 ± 6.3 beats/min, t = 5.41, P \ 0.001; 83.1 ± 5.3 vs. 84.8 ± 5.6 beats/min, t = 3.75, P \ 0.001, respectively), while SBP and DBP were similar between the two groups. The incidence of adverse events during labor was also similar between the two groups. Conclusion: The present study showed that dexmedetomidine could reduce the incidence of intrapartum fever and relieve pain during labor without increasing adverse events. Trial Registration: ChiCTR-OPC-16008548. Keywords: Analgesia; Epidural; midine; Intrapartum fever; Labor
Dexmedeto-
Pain Ther
METHODS Key Summary Points The mechanisms of intrapartum fever are controversial. Dexmedetomidine increases analgesic effects. Dexmedetomidine may reduce the incidence of intrapartum fever.
DIGITAL FEATURES This article is published with digital features to facilitate understanding of the articl
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