Effect of Epidural Dexmedetomidine vs Nalbuphine for Labor Analgesia: A Randomized Clinical Trial

• Published in: QJM : An International Journal of Medicine Vol. 116; no. Supplement_1
• Main Authors: EL Kabarity, Reem Hamdy, El Fawal, Sanaa Mohammed, Abd El Tawab, Samar Mohammed, Ahmed, Nourhan Tarek Fouad
• Format: Journal Article
• Language: English
• Published: 23.08.2023
• ISSN: 1460-2725; 1460-2393
• DOI: 10.1093/qjmed/hcad069.087

Abstract Background The addition of dexmedetomidine or nalbuphine to epidural bupivacaine was tested to reduce labor pain in women undergoing normal delivery. Patients and Methods 64 patients were randomly allocated into two groups of 32 parturients each with conscent from parturients. Groups A and B received a bolus of 12 ml volume consisting of 11 ml of 0.25% bupivacaine and 0.5 μg/ml dexmedetomidine (1 ml volume) through the epidural catheter and then a top up dose of 6 ml volume consisting of 5 ml of 0.25% bupivacaine and 0.5 μg/ml dexmedetomidine (1 ml volume) were given when VAS score becomes 4 or more and a bolus of 12 ml volume consisting of 11 ml of 0.25% bupivacaine and 10 mg nalbuphine (1 ml volume) through the epidural catheter and then a top up dose of 5 ml of 0.25% bupivacaine and 2 mg nalbuphine (1 ml volume) respectively. Assessments included VAS score for pain, vital data monitoring, recording of duration of stages of labor, neonatal APGAR score and adverse effects. Results Parturients in both groups had satisfactory labor analgesia, but those in the dexmedetomidine group had lower pain scores than those in the nalbuphine group. Taking into consideration that dexmedetomidine had a faster onset than nalbuphine. Conclusion Epidural dexmedetomidine seems to offer some advantages over epidural nalbuphine. Thus, it can be used effectively and safely as an adjuvant to epidural bupivacaine in labor analgesia.