PCIA with Dezocin and Infused Dexmedetomidine in Labor Analgesia

Objective: To investigate the analgesic efficacy and safety of patient controlled intravenous analgesia(PCIA) with dezocin and infused dexmedetomidine for labor analgesia.Method: Ninty ASA I-II full term primigravidae in active labor who had a single fetus with vertex presentation and were expected to have a vaginal delivery were randomly divided into 3 groups: I control group(n=30) received no analgesia;group A(n=30) and group B(n=30) received analgesia.In group A the loading dose of dezocin(0.15mg/kg) and dexmedetomidine(1 ug/kg) were infused,infused dexmedetomidine(0.4ug/kg.h)and PCIA with 0.05% dezocin(background infusion 4mL/h,demand bolus 2mL with a 15 min lockout interval and a total dose limit of 60mg);In group B,a catheter was advanced 4cm into epidural space cephalad at L2-3.10mL 0.125% ropivacaine with fentanyl 1.5 ug/mL was infused into epidural space cephalad,and PCEA with 0.125% ropivacaine with fentanyl 1.5 ug/mL(background infusion 4mL/h,demand bolus 4mL with a 15 min lockout interval).The intensity of pain was evaluated by patients using VAS.The vital signs(BP,HR,SPO2),fetal heart rate,labor process,mode of delivery,Apgar score of neonates and side effects of analgesia were recorded.Result: Good analgesia was achieved with high patient satisfaction in group A(94.8%) and B(95.6%) as compared with control group,but there was no significant difference in VAS score between group A and B.there was no significant difference in Apar score among the 3 groups.The duration of second stage of labor was longer in group B than that in group A and control group(P0.05).The rate of cesarean section was significantly in control group than that in group A and B,but the difference between group A and B was not statistically significant.There was no significant difference in vital signs,fetal heart rate and uterine contraction among the 3 group.Conclusion: PCIA with ropivacaine dezocin and infused dexmedetomidine is safe and effective for labor analgesia.