Photo Credit: ChaNaWiT
The following is a summary of “Application of Dexmedetomidine in Epidural Labor Analgesia: A Systematic Review and Meta-Analysis on Randomized Controlled Trials,” published in the January 2024 issue of Pain by Zhang et al.
Researchers conducted a retrospective study to evaluate the effectiveness and safety of dexmedetomidine in conjunction with epidural labor analgesia based on data from RCTs.
They searched for RCTs on epidural labor analgesia with or without dexmedetomidine in PubMed, Cochrane Library, and Embase until November 1, 2022. The main focus was on the visual analog scale (VAS) within 2 hours post-epidural, while secondary outcomes included first and second-stage labor duration, Apgar score, umbilical blood pH, analgesic dosage, and side effects.
The results showed 8 RCTs with 846 parturients, the VAS score in the dexmedetomidine group was notably lower than the control group at 15 minutes (MD -1.41, 95% CI -2.23, -0.59), 30 minutes (MD -1.02, 95% CI -1.70, -0.33), 60 minutes (MD -0.90, 95% CI -1.36, -0.44), and 90 minutes (MD -0.70, 95% CI -1.16, -0.23). The dexmedetomidine group had a lower incidence of pruritus compared to the control group (MD 0.28, 95% CI 0.11, 0.74) but a higher incidence of maternal bradycardia (MD 6.41, 95% CI 1.64, 25.04). No significant differences were observed in other outcomes.
Investigators concluded that epidural dexmedetomidine with local anesthetic shows promise for pain relief but may increase maternal heart rate slowdowns.
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