Efficacy and Safety of Intrathecal Dexmedetomidine or Morphine as Adjuvant to Bupivacaine for Normal Labor Analgesia: A Randomized Clinical Study | ||||
| The Egyptian Journal of Hospital Medicine | ||||
| Article 80, Volume 100, Issue 1, July 2025, Page 3095-3101 PDF (308.27 K) | ||||
| DOI: 10.21608/ejhm.2025.442419 | ||||
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| Abstract | ||||
| Background: Effective pain management during vaginal labor is crucial for minimizing maternal stress, enhancing the overall birth experience, facilitating labor progression, and promoting the well-being of both mother and newborn. Objective: This study aimed to assess intrathecal dexmedetomidine (DEX) and morphine efficacy and safety in reducing pain during delivery, patient satisfaction, and mother's outcome. Patients and methods: This randomized controlled study included 90 multiparous women, aged 21–40 years, with uncomplicated term pregnancies, requesting analgesia for vaginal delivery. Patients were randomized into two groups to receive spinal analgesia using (0.5 mL 0.5% hyperbaric bupivacaine + 200 µg morphine in 1.5 mL preservative-free saline) in the morphine group and (0.5 mL 0.5% hyperbaric bupivacaine + 5 µg DEX in 1.5 mL saline) in DEX one. Both groups received 2 mL total. Results: Pain scores at delivery, as well as at 90 and 120 minutes postpartum, were significantly lower in the DEX group compared to the morphine group. The DEX group also demonstrated a significantly delayed onset of sensory block and a longer duration of analgesia. Complications and patient satisfaction were comparable between groups. Conclusions: Intrathecal DEX is superior to morphine for normal labor analgesia, as demonstrated by its longer analgesic duration, lower pain scores, effective sensory blockade, and fewer opioid-related side effects. It maintains similar maternal and neonatal outcomes, with comparable patient satisfaction and complication rates. | ||||
| Keywords | ||||
| Intrathecal; Dexmedetomidine; Morphine; Bupivacaine; Labor pain | ||||
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