Abstract

The main aim of this study was to evaluate the safety and efficacy of ropivacaine in combination with varying concentrations of nalbuphine for epidural labor analgesia at reduced doses. A randomized, double-blind, prospective experimental design was used to enroll healthy full-term women who requested epidural labor analgesia at academic medical centers specializing in maternal and child health care. Participants were randomly assigned to one of the five groups with different concentrations of nalbuphine, which includes group A (0 mg/ml), group B (0.3 mg/ml), group C (0.4 mg/ml), group D (0.5 mg/ml) and group E (0.6 mg/ml), with a sample size of 30 patients per group. The effectiveness of the analgesic was defined by the visual analog scale, where score of <3 in 30 min after induction, using the Dixon-Massey sequential method. The median effective concentration of epidural ropivacaine was calculated using the Bonferroni test and the overlapping confidence interval method. Basic maternal profile data, median effective concentration, neonatal outcomes, obstetric aspects, and adverse effects were collected 30 min after injecting epidural local anesthetic. The median effective concentration values in groups C, D and E were significantly lower than those compared to groups A and B. There was no statistically significant difference in median effective concentration values between groups C, D and E. There were no statistically significant differences between the groups in neonatal outcomes, obstetric aspects and adverse effects. Ropivacaine combined with a nalbuphine concentration of 0.4 mg/ml showed the greatest clinical effect, with no additional benefit beyond 0.4 mg/ml and the combined efficacy was efficient, and the safety profile was high.