Evaluating the Effect of Dexmedetomidine Intravenous Infusion on Labour Pain Management in Primipara Pregnant Women: A Nonrandomised Clinical Trial Study

Abstract

Background and aims: The pain of labour is very severe. Most women prefer painless labour to routine labour if they are aware of the methods of analgesia. The aim of this study was to evaluate the effect of dexmedetomidine intravenous infusion on labour pain management in primipara term pregnant women.

Methods: In this nonrandomised clinical trial with control group, all primipara term pregnant women from August 2019 to March 2020 were included. In the intervention group, after the active phase of labour, dexmedetomidine was given according to the protocol and continued until phase 2 of labour. The control group received no intervention to reduce pain. Patients in both groups were evaluated for fetal heart rate, Apgar scores, vital signs, pain intensity, and sedation score.

Results: There were no significant differences in primary fetal heart rate, primary maternal hemodynamics, and mean Apgar scores at 1 and 5 minutes between the two groups (p > .05). There was no significant difference in the mean fetal heart rate in different stages between the two groups. Intragroup analysis in the intervention group showed that mean systolic and diastolic blood pressures were significantly decreased after drug administration but were in the normal range. The active phase of labour in the intervention group was significantly shorter than in the control group (p = 0.002). The mean Visual Analogue Scale (VAS) score after dexmedetomidine administration decreased significantly from 9.25 at baseline to 4.61 after drug administration, 3.88 during labour, and 1.88 after placental expulsion. The mean Ramsay Sedation Scale score after dexmedetomidine administration increased significantly from 1.00 at baseline to 2.05 after drug administration, 2.22 during labour, and 2.05 after placental expulsion.

Conclusion: Based on the study's results, the administration of dexmedetomidine to manage labour pain with careful monitoring of mother and fetus is recommended.

Keywords: dexmedetomidine; intravenous analgesia; painless labour.

Figure 1

Comparison of mean systolic and diastolic blood pressure (mmHg) in the intervention group during the study. I = Primary SBP and DBP; II = during bolus dose of dexmedetomidine; III = during labour; IV = after placental expulsion.

Figure 2

Comparison of mean systolic and diastolic blood pressure (mmHg) in the control group during the study. I = Primary SBP and DBP; III = during labour; IV = after placental expulsion.

Figure 3

Comparison of the mean VAS score in the intervention group during the study. VAS1 = primary VAS; VAS2 = after bolus dose of dexmedetomidine; VAS3 = during labour; VAS4 = after placental expulsion.