Dexamethasone as a sufentanil adjuvant effects on labor pain management and neonatal safety

The purpose of this study was to evaluate the effect of adding low-dose bupivacaine-dexamethasone for intrathecal labor analgesia in vaginal delivery.

This study was conducted as a clinical trial on full-term, singleton pregnant women aged between 20 and 40 years, who were candidates for natural childbirth and were in the second phase of the first stage of labor. Patients were randomly assigned to either the control group, which received only a single-shot intrathecal injection of 5 μg of sufentanil, or the intervention group, which, in addition to receiving spinal anesthesia with a single-shot intrathecal injection of 5 μg of sufentanil, also received an intrathecal injection of 5 mg of dexamethasone. The variables examined included the duration of maternal pain relief during the natural childbirth process, the time of the first request for additional pain relief by the mother during the natural childbirth process, maternal vital signs, and the arterial blood gas (ABG) of the newborn at birth, comparing the two groups.

The average duration of analgesia was 237.67 ± 53.46 minutes in the case group, which was significantly higher than the average analgesia time in the control group with 149.57 ± 68.82 (P < 0.001). Also, the average time of request to repeat analgesia was 235.33 ± 47.41 in the case group, which was longer than the control group with 140.78 ± 90.90 (P < 0.001). In general, the course of labor in the case group was 288.00 ± 45.45 minutes shorter than the control group by 375.00 ± 181.12 minutes (P = 0.019).

The simultaneous addition of dexamethasone to sufentanil during natural childbirth can increase the time of analgesia and the time of request to repeat analgesia and decrease the duration of labor. The simultaneous use of dexamethasone and sufentanil is recommended in comparison with sufentanil alone due to its safety for the mother and child and the creation of more favorable analgesia during vaginal childbirth.