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INTRODUCTION: This review and meta-analysis comprehensively elaborated the analgesic and sedative effects of ropivacaine combined with dexmedetomidine in epidural labor analgesia, and its possible resulting motor block and adverse reactions. @@@ EVIDENCE ACQUISITION: PubMed, Web of science, Cochrane, China National Knowledge Infrastructure and WAN-FANG DATA were searched for randomized controlled trials (RCTs) on the efficacy and safety of ropivacaine combined with dexmedetomidine in epidural labor analgesia. Standard mean difference (SMD) and 95% confidence interval (CI) were calculated. @@@ EVIDENCE SYNTHESIS: As of September 10(th), 17 articles were finally included for meta-analysis. The results showed that compared with the control group (ropivacaine alone or ropivacaine + sufentanil), singleton full-term pregnant patients treated with ropivacaine + dexmedetomidine had better analgesic and sedative effects, with lower VAS scores at 15 min (T-1), 30 min (T-2), 1 h (T-3), 2 h (T-4) after labor analgesia, and the moment of delivery (T-5) (T-1: SMD=-1.90, 95% CI: -2.39, -1.40; T-2: SMD=-1.43, 95% CI: -1.92, -0.93; T-3: SMD=-0.91, 95% CI: -1.41, -0.41; T-4: SMD=-0.94, 95% CI: -1.54, -0.34; T-5: SMD=-0.56, 95% CI: -1.02, -0.10) and higher Ramsay scores at 15 min (T-1) and 30 min (T-2) after labor analgesia (T-1: SMD=1.17, 95% CI: 0.80, 1.53; T-2: SMD=2.17, 95% CI: 1.30, 3.03). @@@ CONCLUSIONS: In patients with singleton full-term pregnancy, ropivacaine + dexmedetomidine have better analgesic and sedative effects than in the control group. Both groups have no significant motor block and neonatal asphyxia and hypoxia.
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单位南方医科大学
