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已发表论文
硬脊膜穿破硬膜外技术用于分娩镇痛时右美托咪定辅助罗哌卡因半数有效浓度（EC50）的测定：一项序贯升降分配研究
Authors Wang XY, Liu H, Zhang J, Shi J, Zhao Y, Liang Y
Received 2 October 2025
Accepted for publication 14 January 2026
Published 5 February 2026 Volume 2026:20 571808
DOI https://doi.org/10.2147/DDDT.S571808
Checked for plagiarism Yes
Review by Single anonymous peer review
Peer reviewer comments 3
Editor who approved publication: Professor Anastasios Lymperopoulos
Xin Yu Wang,1,2 Hui Liu,1 Jie Zhang,3 Jianwen Shi,1,2 Yang Zhao,3 Yongxin Liang1,2
1Department of Anesthesiology, Women and Children’s Hospital, Qingdao University, Qingdao, Shandong, People’s Republic of China; 2Department of Anesthesiology, Peking University People’s Hospital, Qingdao, Shandong, People’s Republic of China; 3Department of Anesthesiology, The Affiliated Hospital of Qingdao University, Qingdao, Shandong, People’s Republic of China
Correspondence: Yongxin Liang, Department of Anesthesiology, Women and Children’s Hospital, Qingdao University, Tongfu Road No. 6, Shibei District, Qingdao, 266000, People’s Republic of China, Email Liangzi66@hotmail.com
Background: The dural puncture epidural (DPE) technique offers a promising option for managing labor pain. While dexmedetomidine has proven clinically efficacious in labor pain, its optimal concentration in DPE technique remains underexplored. This trial was designed to identify the ideal adjuvant concentration of dexmedetomidine to ropivacaine in the DPE technique for labor analgesia.
Methods: Parturients were randomly allocated to six groups receiving different concentrations of dexmedetomidine (0, 0.1, 0.2, 0.3, 0.4, and 0.5 μg/mL). In each group, ropivacaine was initiated at 0.1% concentration. Effective analgesia was defined as visual analog scale scores ≤ 3 during two consecutive uterine contractions within 30 minutes; if achieved, the ropivacaine concentration for subsequent parturients was reduced by 0.01%, otherwise increased by 0.01%.
Results: The median effective concentrations of ropivacaine at dexmedetomidine concentrations of 0.3, 0.4, and 0.5 μg/mL were 0.042% (95% CI: 0.035%– 0.049%), 0.036% (95% CI: 0.030%– 0.043%), and 0.037% (95% CI: 0.030%– 0.044%), which were lower than those at 0, 0.1, and 0.2 μg/mL (0.079% [95% CI: 0.071%– 0.088%], 0.070% [95% CI: 0.062%– 0.078%], and 0.059% [95% CI: 0.053%– 0.066%]). Comparisons between the three highest dexmedetomidine doses showed no significant differences. Scores on the Ramsay Sedation Scale were significantly elevated in the three highest concentration groups compared to the 0 and 0.1 μg/mL groups. Additionally, the scores for the 0.3 and 0.5 μg/mL groups exceeded that of the 0.2 μg/mL group. Comparisons involving the 0.2 μg/mL group versus the 0.4 μg/mL group, as well as those among the three highest concentration groups, all showed no statistical difference.
Conclusion: For labor analgesia using the DPE technique, 0.3 μg/mL dexmedetomidine is the optimal adjuvant concentration to ropivacaine, balancing analgesic efficacy and safety. Higher concentrations do not enhance analgesia but may increase the risk of sedation.
Keywords: dural puncture epidural technique, dexmedetomidine, median effective concentration, labor analgesia
1Department of Anesthesiology, Women and Children’s Hospital, Qingdao University, Qingdao, Shandong, People’s Republic of China; 2Department of Anesthesiology, Peking University People’s Hospital, Qingdao, Shandong, People’s Republic of China; 3Department of Anesthesiology, The Affiliated Hospital of Qingdao University, Qingdao, Shandong, People’s Republic of China
Correspondence: Yongxin Liang, Department of Anesthesiology, Women and Children’s Hospital, Qingdao University, Tongfu Road No. 6, Shibei District, Qingdao, 266000, People’s Republic of China, Email Liangzi66@hotmail.com
Background: The dural puncture epidural (DPE) technique offers a promising option for managing labor pain. While dexmedetomidine has proven clinically efficacious in labor pain, its optimal concentration in DPE technique remains underexplored. This trial was designed to identify the ideal adjuvant concentration of dexmedetomidine to ropivacaine in the DPE technique for labor analgesia.
Methods: Parturients were randomly allocated to six groups receiving different concentrations of dexmedetomidine (0, 0.1, 0.2, 0.3, 0.4, and 0.5 μg/mL). In each group, ropivacaine was initiated at 0.1% concentration. Effective analgesia was defined as visual analog scale scores ≤ 3 during two consecutive uterine contractions within 30 minutes; if achieved, the ropivacaine concentration for subsequent parturients was reduced by 0.01%, otherwise increased by 0.01%.
Results: The median effective concentrations of ropivacaine at dexmedetomidine concentrations of 0.3, 0.4, and 0.5 μg/mL were 0.042% (95% CI: 0.035%– 0.049%), 0.036% (95% CI: 0.030%– 0.043%), and 0.037% (95% CI: 0.030%– 0.044%), which were lower than those at 0, 0.1, and 0.2 μg/mL (0.079% [95% CI: 0.071%– 0.088%], 0.070% [95% CI: 0.062%– 0.078%], and 0.059% [95% CI: 0.053%– 0.066%]). Comparisons between the three highest dexmedetomidine doses showed no significant differences. Scores on the Ramsay Sedation Scale were significantly elevated in the three highest concentration groups compared to the 0 and 0.1 μg/mL groups. Additionally, the scores for the 0.3 and 0.5 μg/mL groups exceeded that of the 0.2 μg/mL group. Comparisons involving the 0.2 μg/mL group versus the 0.4 μg/mL group, as well as those among the three highest concentration groups, all showed no statistical difference.
Conclusion: For labor analgesia using the DPE technique, 0.3 μg/mL dexmedetomidine is the optimal adjuvant concentration to ropivacaine, balancing analgesic efficacy and safety. Higher concentrations do not enhance analgesia but may increase the risk of sedation.
Keywords: dural puncture epidural technique, dexmedetomidine, median effective concentration, labor analgesia