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

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.