Effectiveness of single-shot intra thecal analgesia in multiparous women scheduled for normal vaginal delivery

Abstract

Background and Aims: Spinal analgesia is used as pain relief method during labor. This cross-sectional study was conducted to assess the effect of adding dexmedetomidine, fentanyl to low-dose bupivacaine for intrathecal labour analgesia in multiparous women.Methods: A total of 75 women in the active phase of labor were randomly allocated to have intrathecal bupivacaine with dexmedetomidine (group D), fentanyl (group F), or saline (placebo) (group C). The duration of analgesia, intrathecal block characteristics and maternal and foetal outcomes were assessed and analysed.Results: The longest analgesia duration and S1 regression time was recorded in group D followed by groups F and C. The shortest analgesia onset time and the highest sensory levels were recorded in both group D and group F then group C. Visual analogue scale values were comparable among groups F and D at most of the measurement time points and at the peak of the last uterine contraction before delivery while being significantly lower than those in group C. However, there were similar motor block characteristics and normal neonatal outcomes in all groups.Conclusion: Single-dose intrathecal analgesia is a safe, fast, and efficient technique for labor analgesia, which can be easily performed, In comparison to fentanyl, dexmedetomidine addition to intrathecal bupivacaine significantly prolonged the duration of labour analgesia, with a good maternal and neonatal outcome.