Efficacy of dexmedetomidine or intravenous tramadol for obstetric analgesia during labor
Abstract
Labor pain ranges from moderate to severe intensity due to uterine contractions, cervical dilation, and stimulation of perineo-vaginal-rectal structures. Objective: To determine the effectiveness of dexmedetomidine and tramadol for analgesia during labor. Methodology: A comparative, prospective, and cross-sectional non-experimental study. Thirty parturients who received analgesia during labor were evaluated in two groups during the early phase of labor. Dexmedetomidine intravenous group (n=15). Tramadol intravenous group (n=15). Results: Similar sociodemographic characteristics, age 22 + 7 years (Dexmedetomidine) and 24 + 3 years (Tramadol). Gestational age 39 + 1.2 weeks (Dexmedetomidine) and 39 + 0.9 weeks (Tramadol). ASA II. Systolic blood pressure showed a decrease in the Dexmedetomidine group, stabilizing thereafter throughout labor. Diastolic pressure remained the same in both groups. Heart rate was elevated in the Tramadol group. Oxygen saturation was maintained in the Dexmedetomidine group. Dexmedetomidine had a better analgesic effect (VAS: 5), delivery (3), and immediate postpartum (2). Only the tramadol group had adverse effects. Conclusion: Dexmedetomidine is an effective and tolerated analgesic during labor, without causing cardiorespiratory depression and without altering uterine activity, its use in obstetrics is recommended.
Downloads
References
Amezcua A, Vega A, García M, López E, Salas M, Martínez J, Molero I, Garrido M, Peñaranda G, García A, Atienza Y, Flores B, Molina A, Campillo E. (2017). Valoración y manejo del dolor en el parto y puerperio. Gerencia de Atención Integrada de Albacete. (Citado 01 de marzo de 2024). Disponible en: https://www.chospab.es/publicaciones/protocolosEnfermeria/documentos/5098f7032b67219d0ca9da2f69d86815.pdf
Blumberg MJ. (2000). Analgesia durante el trabajo de parto y el parto vaginal. Rev. Arg. Anest; 6: 365-377. (Citado 01 de marzo de 2024). Disponible en: https://www.anestesia.org.ar/search/articulos_completos/1/1/191/c.pdf
Delavari A, Dehgan M, Lak M. (2022). Evaluating the Effect of Dexmedetomidine Intravenous Infusion on Labour Pain Management in Primipara Pregnant Women: A Nonrandomised Clinical Trial Study. Rom J Anaesth Intensive Care;28(1):10-18. (Citado 01 de marzo de 2024). Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9949007/
Duarte-Medrano G. (2022). Dexmedetomidina, tendencias y actuales aplicaciones. Rev. Chil. Anest; 51 (3): 265-272. (Citado 01 de marzo de 2024). Disponible en: https://revistachilenadeanestesia.cl/PII/revchilanestv5115031153.pdf
Espinoza E, Arévalo C, Abril C. (2015). Ensayo Clínico Aleatorizado: Eficacia Analgésica del Tramadol Durante la Fase Activa del Parto. Rev Med HJCA; 7(3): 210-215. (Citado 01 de marzo de 2024). Disponible en: http://dx.doi.or-g/10.14410/2015.7.3.ao.38
Fan M, Li J, Cao R, Hu L, Lu S. (2022). Efficacy and safety of dexmedetomidine-ropivacaine versus sufentanil-ropivacaine for epidural labor analgesia: a randomized controlled. Ann Palliat Med;11(4):1410-1420. (Citado 01 de marzo de 2024). Disponible en: https://apm.amegroups.org/article/view/93811/pdf
Gambling DR. (2019). Intravenous dexmedetomidine. Int J Obstet Anesth; 39:148. (Citado 01 de marzo de 2024). Disponible en: https://pubmed.ncbi.nlm.nih.gov/30846218/
Gomezese OF y Estupiñan B. (2017). Analgesia obstétrica: situación actual y alternativas. Rev Colomb Anestes; 45(2):132-135. (Citado 01 de marzo de 2024). Disponible en: https://www.elsevier.es/es-revista-revista-colombiana-anestesiologia-341-articulo-analgesia-obstetrica-situacion-actual-alternativas-S0120334717300060
Keskin HL, Aktepe E, Avsar A, Tabuk M, Caglar G. (2003). Pethidine versus tramadol for pain relief during labor. International Journal of Gynecology & Obstetrics; 82(1):11-16. (Citado 01 de marzo de 2024). Disponible en: https://www.sciencedirect.com/science/article/abs/pii/S002072920300047X
Liu S, Peng P, Hu Y, Liu C, Cao X, Yang C, Gao M. (2021).The Effectiveness and Safety of Intravenous Dexmedetomidine of Different Concentrations Combined with Butorphanol for Post-Caesarean Section Analgesia: A Randomized Controlled Trial, Drug Design, Development and Therapy; 15: 689-698. (Citado 01 de marzo de 2024). Disponible en: https://www.tandfonline.com/doi/full/10.2147/DDDT.S287512?scroll=top&needAccess=true
Matos H y García M. (2023). Uso de la ketamina endovenosa en anestesiología: revisión de la evidencia y mejores prácticas. Rev. Chil. Anest; 52 (6): 576-579. (Citado 01 de marzo de 2024). Disponible en: https://revistachilenadeanestesia.cl/PII/revchilanestv52n6-03.pdf
Matute M y Montero A. (2017). Avances farmacológicos en el manejo multimodal de la analgesia perioperatoria. Revista Española de Anestesiología y Reanimación; 64(8), 467–471. (Citado 01 de marzo de 2024). Disponible en: https://doi.org/10.1016/j.redar.2017.03.006
Mendoza-Villa JM. (2012). Dexmedetomidine as adjunct for analgesia in labor: a report of two cases. Rev Colomb Anestesiol; 40(1):79-81. https://www.elsevier.es/es-revista-colombian-journal-anesthesiology-342-pdf-S2256208712400141
Palet-Rodríguez M y Torrubia-Pérez E. (2023). Utilidad de las terapias complementarias en el manejo de dolor durante el parto: una revisión integradora. Enferm. Glob; 22(70): 465-496. (Citado 01 de marzo de 2024). Disponible en: https://scielo.isciii.es/scielo.php?script=sci_arttext&pid=S1695-61412023000200017
Sha X, Hu H, Yang J, Fang D, Li W, Zhang H, Coonrod V, Liu H. (2022). Interventions to reduce the cesarean delivery rate in a tertiary hospital in China. J Matern Fetal Neonatal Med;35(1):30-38. (Citado 01 de marzo de 2024). Disponible en: https://pubmed.ncbi.nlm.nih.gov/31875731/
Shafeinia A, Rokhtabnak F, Sehat S, Khosravian G, Rahimzadeh P. (2023). Effect of adding dexmedetomidine on two methods of labor analgesia via epidural among parturient patients. Caspian Journal of Internal Medicine; 14 (4): 648 – 655. (Citado 01 de marzo de 2024). Disponible en: https://pubmed.ncbi.nlm.nih.gov/38024180/
Sun J, Xiao Y, Zou L, Liu D, Huang T, Zheng Z, Yan X, Yuan A, Li Y, Huang X. (2020). Epidural Labor Analgesia Is Associated with a Decreased Risk of the Edinburgh Postnatal Depression Scale in Trial of Labor after Cesarean: A Multicenter, Prospective Cohort Study. Biomed Res Int; 2020:2408063. (Citado 01 de marzo de 2024). Disponible en: https://pubmed.ncbi.nlm.nih.gov/32025517/
Vidal J. (2020). Versión actualizada de la definición de dolor de la IASP: un paso adelante o un paso atrás. Rev Soc Esp Dolor; 27(4): 232-233. (Citado 01 de marzo de 2024). Disponible en: https://www.resed.es/Ficheros/678/2/03_3839-2020_AD.pdf
Viegas OAC, Khaw B, Ratnam SS. (1993). Tramadol in labour pain in primiparous patients. A prospective comparative clinical trial. European Journal of Obstetrics & Gynecology and Reproductive Biology; 49(3):131-135. (Citado 01 de marzo de 2024). Disponible en: https://www.sciencedirect.com/science/article/abs/pii/002822439390260J
Wangping Z y Ming R. (2017). Optimal Dose of Epidural Dexmedetomidine Added to Ropivacaine for Epidural Labor Analgesia: A Pilot Study. Evid Based Complement Alternat Med. 2017;2017:7924148. h t t p s : / / d o i . o r g / 1 0 . 11 5 5 / 2 0 1 7 / 7 9 2 4 1 4 8PMID:28656055
Weerink MA, Struys MM, Hannivoort LN, Barends CR, Absalom AR, Colin P. (2017). Clinical Pharmacokinetics and Pharmacodynamics of Dexmedetomidine. Clin Pharmacokinet;56(8):893–913. https://doi.org/10.1007/s40262-017-0507-7PMID:28105598
Zhang D, Sun Y, Li J. (2024). Application of Dexmedetomidine in Epidural Labor Analgesia: A Systematic Review and Meta-Analysis on Randomized Controlled Trials. Clin J Pain;40(1):57-65. (Citado 01 de marzo de 2024). Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10712998/#:~:text=Dexmedetomidine%20combined%20with%20local%20anesthetic,for%20the%20parturients%20and%20fetuses.
Copyright (c) 2026 Yenireth Lunar, Millán Nelson, Nidia Devonish
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
Copyright
Authors who publish in this journal agree to the following terms:
Authors retain copyright and grant the journal the right to be the first publication where the article is submitted, which is published under a Creative Commons Attribution License, which allows others to share the work upon acknowledgment of authorship of the work and initial publication in this journal.
Authors may separately enter into additional agreements for non-exclusive distribution of the version of the work published in the journal (e.g., placing it in an institutional repository or publishing it in a book), with an acknowledgement of its initial publication in this journal.
This work is licensed under the license:
Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International (CC BY-NC-SA 4.0).
3.png)
_.jpg)
_(1).jpg)
1.jpg)
