Citation Information :
Rathod S, Syal GG, Sood R, Syal K. Intrathecal Labor Analgesia Using Dexmedetomidine: A Viable Alternative to Epidural Analgesia. J South Asian Feder Obs Gynae 2021; 13 (5):279-282.
Aims and objectives: The aims and objectives of the study were to compare the safety and efficacy of single dose intrathecal analgesia using bupivacaine and fentanyl with either dexmedetomidine or morphine on maternal and fetal outcome.
Materials and methods: One-hundred and twenty parturients with uncomplicated pregnancy in spontaneous or induced labor at cervical dilatation 4–6 cm were enrolled for the study. They were randomized into two groups of 60 each. Group I received dexmedetomidine 5 µg (1 mL) and group II received morphine 250 µg (1 mL) along with 0.5% bupivacaine heavy 2.5 mg (0.5 mL) + Fentanyl 25 µg (0.5 mL). Progress of labor, duration of analgesia, and neonatal APGAR score was recorded and compared between the two groups.
Result: The mean rate of cervical dilatation in group I was 1.63 ± 0.135 cm/hour whereas it was 1.54 ± 0.156 cm/hour in group II (p = 0.001). The mean total duration of labor in group I was 682.35 ± 60.920 minutes whereas it was 771.63 ± 52.016 minutes (p = 0.005). In the group I, 98.3% (59/60) had NVD, 1.7% (1/60) had IVD, and none had cesarean delivery. Similarly 75% (45/60) had NVD, 15% (9/60) had IVD, and 10% (6/60) had cesarean delivery in the group II. This difference was statistically significant (p = 0.001). However, duration of the second stage of labor, duration of labor analgesia, maternal satisfaction, and APGAR score did not differ in the two groups.
Conclusion: Single-shot intrathecal labor analgesia using combination of bupivacaine (2.5 mg), fentanyl (25 µg), and dexmedetomidine (5 µg) is a safe, effective, reliable, cheap, and satisfactory method of pain relief for labor and delivery.
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