Effects of Dexmedetomidine or Sufentanil Plus Low-Dose Ropivacaine for Epidural Labor Analgesia on Maternal Intrapartum Temperature Changes and Delivery Outcomes

Abstract

Purpose To compare the effects of dexmedetomidine versus sufentanil combined with low-dose ropivacaine for epidural labor analgesia on maternal intrapartum temperature and delivery outcomes. Methods 612 full-term parturients receiving epidural analgesia were randomized into dexmedetomidine or sufentanil groups (both combined with ropivacaine, maintaining VAS <4). Baseline characteristics, analgesic efficacy, intrapartum temperature, fetal heart rate (FHR), delivery outcomes, and neonatal transfer rates were compared. Risk factors for cesarean section were analyzed. Results Baseline characteristics were similar except for a higher adverse pregnancy history in the dexmedetomidine group (37.66% vs 22.04%, p=0.001). Analgesic efficacy, labor duration, FHR, and Apgar scores did not differ between groups. Temperatures were similar at 1 h and 10 h post-analgesia, but the dexmedetomidine group exhibited significantly lower temperatures at 2 h, 4 h, 6 h, and 8 h (p<0.05). Elevated BMI, advanced gestational age, nulliparity, and oxytocin use were independent risk factors for cesarean section, while vaginal examinations were protective; however, these factors demonstrated low predictive value (AUC<0.7). Neonatal transfer rates were comparable between groups. Conclusion Both regimens provide equivalent analgesic efficacy and maternal-neonatal safety. Dexmedetomidine attenuates intrapartum temperature elevation, suggesting a potential advantage for intrapartum temperature management. Multicenter studies are warranted to confirm these findings. Clinical Trial Registration Registered at the Chinese Clinical Trial Registry (ChiCTR2500108053) on August 25th, 2025.