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Nalbuphine reduces the dose of ropivacaine for epidural labor analgesia: a randomized, double-blind, controlled study
Received:November 12, 2020  Revised:March 10, 2021  Click here to download the full text
Citation of this paper:CHEN Yao-bing,LIU Jing-jing,SUN Xing-feng,HUANG Shao-qiang.Nalbuphine reduces the dose of ropivacaine for epidural labor analgesia: a randomized, double-blind, controlled study[J].Chinese Journal of Clinical Medicine,2021,28(3):381-386
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Author NameAffiliationE-mail
CHEN Yao-bing Department of Anesthesiology, Obstetrics and Gynecology Hospital, Fudan University, Shanghai 200093, China  
LIU Jing-jing Department of Anesthesiology, Obstetrics and Gynecology Hospital, Fudan University, Shanghai 200093, China  
SUN Xing-feng Department of Anesthesiology, Obstetrics and Gynecology Hospital, Fudan University, Shanghai 200093, China  
HUANG Shao-qiang Department of Anesthesiology, Obstetrics and Gynecology Hospital, Fudan University, Shanghai 200093, China timrobbins71@163.com 
Abstract:Objective: To explore the effect of nalbuphine mixed with ropivacaine on epidural labor analgesia. Methods: From October 2019 to February 2021, 104 cases of puerpera from Obstetrics and Gynecology Hospital, Fudan University were selected. 104 parturients were randomly divided into two groups:nalbuphine group (N group, n=52) and ropivacaine group (L group, n=52).The L2-3 space was selected for epidural puncture, and the test dose was given after successful puncture and supine. In group N, a mixture of 10 mL of 0.1% ropivacaine + 0.3 mg/mL nalbuphine was injected epidural. After 30 min, patient-controlled epidural analgesia was performed with the same concentration mixture, with background dose of 6 mL/h, patient-controlled-analgesia (PCA) dose of 6 mL and locking time of 15 min. Except that no nalbuphine was used in group L, other drugs and analgesic procedures were the same as those in group N. The analgesic onset time, first PCA time, visual analogue scale (VAS) score, analgesic adverse reactions were recorded. After analgesia, the total drug consumption and Apgar score of newborn were recorded. Results: Compared with the first PCA time in group L (71.7±41.4) min, the first PCA time in group N (102.4±73.1) min was prolonged (P=0.013) and the onset time was shortened[(21.6±7.9) min vs (17.2±8.6) min, P=0.009)]. The consumption per hour of ropivacaine in group N (10.4±3.6) mg was lower than that in group L(12.8±4.7) mg, (P=0.004). Compared with group L, the number of PCA compression (P=0.045) and effective compression (P=0.003) in group N decreased. The obstetric outcomes were similar between the two groups. Conclusions: 0.3 mg/mL nalbuphine mixed with ropivacaine could reduce the dosage of ropivacaine per unit time, provide satisfactory analgesic effect, and have few adverse reactions, so it may be an optional analgesic scheme for epidural labor analgesia.
keywords:nalbuphine  amides  analgesia  obstetrics  ropivacaine  epidural
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