%0 Journal Article
%T Comparative Effects of Single Shot Intrathecal Bupivacaine with Dexmedetomidine and Bupivacaine with Fentanyl on Labor Outcome
%A S. Fyneface-Ogan
%A O. Gogo Job
%A C. E. Enyindah
%J ISRN Anesthesiology
%D 2012
%R 10.5402/2012/816984
%X Background. Effective intrapartum analgesia attenuates pain, stress, and anxiety which cause release of stress hormones as well as beta-endorphins. Aim. The purpose of this study was to determine the effect of adding dexmedetomidine to hyperbaric bupivacaine for neuraxial analgesia for labor. Methods. Ninety laboring multiparous women were allocated to have single shot intrathecal bupivacaine alone (B), bupivacaine with fentanyl (BF), or bupivacaine with dexmedetomidine (BD). Sensory and motor block characteristics; time from injection to two dermatome sensory regression, sensory regression to S1 dermatome, and motor block regression to Bromage 1 were recorded. Labor pain was assessed with a 10 cm verbal pain scale. Results. Peak sensory block levels in the three groups were essentially the same ( ). The time for sensory and motor blocks to reach T10 dermatome and Bromage 1, respectively, was faster in group BD than in the other groups ( ). The time for sensory regression to S1 was significantly prolonged in the group BD ( ). Motor block regression time to Bromage 1 was also prolonged in the group BD ( ). Neonatal outcome was normal in all groups. Conclusion. Single shot intrathecal bupivacaine/dexmedetomidine significantly prolonged sensory block in laboring women. 1. Introduction Pain during childbirth has been described by women as severe [1] and frequent; these parturients especially those in the developing countries have few or no options for labor pain relief during childbirth. Parenteral opioids and sedatives are the most frequently prescribed agents for women in labor in many poor resource settings [2]. This method of pain relief has been shown to have little or no effect on labor pain [3]. Pain relief not only provides patient¡¯s comfort, but also attenuates the release of stress hormones, whose actions can draw from the parturients¡¯ reserves as well as depriving the fetus of oxygen and nutrients [1]. The provision of effective labor analgesia is now known to decrease the inhibitory effects of endogenous maternal catecholamine on uterine contractility, attenuates maternal acidosis, and improves intrapartum maternal well-being. Although the gold standard in labor analgesia is the utilization of epidural services [2] which are widely used to provide pain-free labor in many parts of the world and have the advantage of providing flexibility to meet the needs of each patient [4]. The use of single-shot intrathecal low dose bupivacaine for labor analgesia has been demonstrated and found to be effective [5]. The advantages of this form of technique
%U http://www.hindawi.com/journals/isrn.anesthesiology/2012/816984/