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已发表论文
右美托咪定局部浸润作为辅助用药对硬膜外分娩镇痛期间突发疼痛的影响：一项随机对照试验
Authors Liu D , Wang X, Wu XX, Ouyang RN , Niu JY , Tao QY , Wang YH , Wang J, Zhu H, Zhang F, Zhu HJ , Yu JM
Received 15 July 2025
Accepted for publication 27 November 2025
Published 2 December 2025 Volume 2025:19 Pages 10621—10631
DOI https://doi.org/10.2147/DDDT.S553879
Checked for plagiarism Yes
Review by Single anonymous peer review
Peer reviewer comments 3
Editor who approved publication: Professor Anastasios Lymperopoulos
Dong Liu,1,* Xu Wang,1,* Xiao-Xuan Wu,2,* Rui-Ning Ouyang,1 Jing-Yi Niu,1 Qing-Yu Tao,1 Ya-Hui Wang,1 Jing Wang,1 Hao Zhu,1 Fang Zhang,3 Hai-Juan Zhu,2 Jun-Ma Yu1
1Department of Anesthesiology, the Third Affiliated Hospital of Anhui Medical University (The First People’s Hospital of Hefei), Hefei, Anhui, People’s Republic of China; 2Department of Anesthesiology, the Maternal and Child Health Hospital of Anhui Medical University, Hefei, Anhui, People’s Republic of China; 3Department of Birthing Center, the Maternal and Child Health Hospital of Anhui Medical University, Hefei, Anhui, People’s Republic of China
*These authors contributed equally to this work
Correspondence: Jun-Ma Yu, Department of Anesthesiology, the Third Affiliated Hospital of Anhui Medical University (The First People’s Hospital of Hefei), 390 Huaihe Road, Hefei, Anhui, 230061, People’s Republic of China, Tel +8655162181915, Email majuny163@163.com Hai-Juan Zhu, Department of Anesthesiology, the Maternal and Child Health Hospital of Anhui Medical University, 15 Yimin Street Hefei, Hefei, Anhui, 230001, People’s Republic of China, Tel +8655168116157, Email 35880762@qq.com
Purpose: Evaluation of the effectiveness of local dexmedetomidine and ropivacaine administration prior to epidural puncture in reducing breakthrough pain during labor analgesia.
Methods: A total of 267 parturients were enrolled in this study and allocated to three groups: Group C (n=86) received 0 μg/kg (control), Group D1 (n=87) received 0.4 μg/kg, and Group D2 (n=92) received 0.6 μg/kg. Dexmedetomidine combined with 0.5% ropivacaine (3 mL) was applied locally at the epidural puncture site. The primary outcome was the incidence of breakthrough pain during labor. The secondary outcomes included visual analog scale (VAS) score at the puncture site on days 3, 7, and 42 postpartum; the Edinburgh Postnatal Depression Scale (EPDS) score and Pittsburgh Sleep Quality Index score at prenatal, 7–day postpartum, and 42–day postpartum. In addition, the Apgar scores and umbilical artery blood gas status at 1 and 5 minute and the need for neonatal ward admission were also collected.
Results: The incidence of breakthrough pain episodes was markedly lower in the Group D1 (23 of 87 [26.4%] vs 43 of 86 [50.0%]; odds ratio [OR], 0.395; 95% confidence interval [CI], 0.190– 0.675; p = 0.002) and Group D2 (21 of 92 [22.8%] vs 43 of 86 [50.0%]; OR, 0.296; 95% CI, 0.155– 0.564; p < 0.001) than in the Group C. Postpartum analysis revealed significantly lower VAS scores for puncture site pain in Groups D1 and D2 than in Group C at the 3-days postpartum (p < 0.001). Parturients in Group D2 demonstrated a significant reduction in EPDS scores compared to Group C at postpartum day 7.
Conclusion: Administering local infiltration of 0.4 μg/kg or 0.6 μg/kg dexmedetomidine prior to epidural puncture in parturients undergoing elective labor analgesia has been shown to be effective in decreasing the incidence of breakthrough pain during labor analgesia.
Trial Registration: The trial has been registered in the Chinese Clinical Trials Registry (ChiCTR2400083244) https://www.chictr.org.cn/showproj.html?proj=227790.
Keywords: breakthrough pain, dexmedetomidine, labor analgesia
1Department of Anesthesiology, the Third Affiliated Hospital of Anhui Medical University (The First People’s Hospital of Hefei), Hefei, Anhui, People’s Republic of China; 2Department of Anesthesiology, the Maternal and Child Health Hospital of Anhui Medical University, Hefei, Anhui, People’s Republic of China; 3Department of Birthing Center, the Maternal and Child Health Hospital of Anhui Medical University, Hefei, Anhui, People’s Republic of China
*These authors contributed equally to this work
Correspondence: Jun-Ma Yu, Department of Anesthesiology, the Third Affiliated Hospital of Anhui Medical University (The First People’s Hospital of Hefei), 390 Huaihe Road, Hefei, Anhui, 230061, People’s Republic of China, Tel +8655162181915, Email majuny163@163.com Hai-Juan Zhu, Department of Anesthesiology, the Maternal and Child Health Hospital of Anhui Medical University, 15 Yimin Street Hefei, Hefei, Anhui, 230001, People’s Republic of China, Tel +8655168116157, Email 35880762@qq.com
Purpose: Evaluation of the effectiveness of local dexmedetomidine and ropivacaine administration prior to epidural puncture in reducing breakthrough pain during labor analgesia.
Methods: A total of 267 parturients were enrolled in this study and allocated to three groups: Group C (n=86) received 0 μg/kg (control), Group D1 (n=87) received 0.4 μg/kg, and Group D2 (n=92) received 0.6 μg/kg. Dexmedetomidine combined with 0.5% ropivacaine (3 mL) was applied locally at the epidural puncture site. The primary outcome was the incidence of breakthrough pain during labor. The secondary outcomes included visual analog scale (VAS) score at the puncture site on days 3, 7, and 42 postpartum; the Edinburgh Postnatal Depression Scale (EPDS) score and Pittsburgh Sleep Quality Index score at prenatal, 7–day postpartum, and 42–day postpartum. In addition, the Apgar scores and umbilical artery blood gas status at 1 and 5 minute and the need for neonatal ward admission were also collected.
Results: The incidence of breakthrough pain episodes was markedly lower in the Group D1 (23 of 87 [26.4%] vs 43 of 86 [50.0%]; odds ratio [OR], 0.395; 95% confidence interval [CI], 0.190– 0.675; p = 0.002) and Group D2 (21 of 92 [22.8%] vs 43 of 86 [50.0%]; OR, 0.296; 95% CI, 0.155– 0.564; p < 0.001) than in the Group C. Postpartum analysis revealed significantly lower VAS scores for puncture site pain in Groups D1 and D2 than in Group C at the 3-days postpartum (p < 0.001). Parturients in Group D2 demonstrated a significant reduction in EPDS scores compared to Group C at postpartum day 7.
Conclusion: Administering local infiltration of 0.4 μg/kg or 0.6 μg/kg dexmedetomidine prior to epidural puncture in parturients undergoing elective labor analgesia has been shown to be effective in decreasing the incidence of breakthrough pain during labor analgesia.
Trial Registration: The trial has been registered in the Chinese Clinical Trials Registry (ChiCTR2400083244) https://www.chictr.org.cn/showproj.html?proj=227790.
Keywords: breakthrough pain, dexmedetomidine, labor analgesia