• Clin J Pain · Jun 2021

    Randomized Controlled Trial Multicenter Study

    The Effect of Epidural Nalbuphine Combined with Ropivacaine on Epidural Analgesia During Labor-- A Multicenter, Randomized, Double-blind, Controlled Study.

    • Xingfeng Sun, Qun Zhou, Min Zhou, Rong Cao, Zuolei Chen, Songjiang Tang, and Shaoqiang Huang.
    • Department of Anesthesiology, Obstetrics and Gynecology Hospital of Fudan University, Shanghai.
    • Clin J Pain. 2021 Jun 1; 37 (6): 437-442.

    ObjectivesThe addition of a small dose of opioids during epidural labor analgesia can enhance the local analgesic effect, reduce the dose of local anaesthetic required, and minimize motor blockade. For the treatment of visceral pain, studies have shown that κ-opioid receptor agonist are more effective than μ-receptor agonists. This study compared the effectiveness of epidural nalbuphine and sufentanil in combination with ropivacaine for labor analgesia, respectively.Materials And MethodsWe conducted a prospective, randomized, double-blind, multicentre clinical trial. Parturients who requested labor pain relief were randomly assigned to either the nalbuphine group or sufentanil group. After 5 minutes of initial dose, parturients in nalbuphine group received 10 mL 0.1% ropivacaine plus 0.3 mg/mL nalbuphine solution. The sufentanil group received the same ropivacaine dose plus 0.3 μg/mL sufentanil. The primary outcome was the duration of analgesia (the time to the first requirement for additional medication). Secondary outcomes included the ropivacaine dose per hour, and adverse reactions.ResultsBetween November 2018 and February 2019, 180 parturients were recruited for the study. The study showed that the duration of analgesia was shorter in the nalbuphine group as compared with the sufentanil group (P=0.040). The ropivacaine dose per hour in nalbuphine group 9.3 (2.4) mg was significantly greater versus sufentanil group 8.4 (2.5) mg (P=0.024). No serious adverse events directly associated with the analgesics were observed.DiscussionThe analgesia effects of 0.3 mg/mL nalbuphine with ropivacaine are inferior to 0.3 μg/mL sufentanil with ropivacaine in labor analgesia. No serious side effects, either in the mother or in the fetus, were observed.Copyright © 2021 Wolters Kluwer Health, Inc. All rights reserved.

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