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For labor analgesia, epidural Dexmedetomidine may be superior to epidural Nalbuphine.
According to a randomized clinical trial published in the Egyptian Journal Of Anaesthesia, Dexmedetomidine had a quicker onset of action than Nalbuphine in alleviating labor pain in women undergoing normal delivery. The purpose of this trial was to explore effect of Dexmedetomidine vs Nalbuphine added to Bupivacaine to mitigate labor pain.
Overall, 64 patients were randomly assigned to two groups of 32 parturients. Groups A (Dexmedetomidine) and B ( Nalbuphine) received a 12 ml volume bolus consisting of 11ml volume of 0.25% Bupivacaine, and 1 mL volume of 0.5 μg/ml Dexmedetomidine using epidural catheter. This was followed by a top-up dosage of 6 ml comprising 1 ml of 0.5 μg/ml Dexmedetomidine and 5 ml of 0.25% Bupivacaine until the visual analog scale (VAS) score reached 4 or more.
A 12 ml volume bolus was administered through epidural, comprising 11 ml of 0.25% Bupivacaine along with 1 ml of 10 mg Nalbuphine. This was followed by a top-up dosage of 5 ml of 0.25% Bupivacaine and 1 ml of 2 mg Nalbuphine. The vital data monitoring, VAS score, APGAR score, duration of stages of labor, and adverse events were all evaluated.
Both epidural Dexmedetomidine and Nalbuphine added to 0.25% Bupivacaine attained satisfactory labor analgesia, without eliciting severe adverse effects. However, the Dexmedetomidine group (due to quicker onset of action) experienced lower pain levels during the trial as compared to Nalbuphine group. Therefore, Dexmedetomidine can be administered as a safe add-on therapy to epidural Bupivacaine in labor analgesia.
Egyptian Journal Of Anaesthesia
Effect of Epidural Dexmedetomidine vs Nalbuphine for Labor Analgesia:#xd; A randomized clinical trial
Sanaa M. El Fawal et al.
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