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Labor epidural analgesia has traditionally relied on the use of local anesthetics combined with lipophilic opioids such as fentanyl and sufentanil to manage labor pain. While opioids provide effective analgesia, their use is associated with several adverse effects, including maternal pruritus, hypotension, bradycardia, and fetal complications such as respiratory depression and lower Apgar scores. In the context of the ongoing opioid epidemic and increasing interest in opioid-sparing techniques, anesthesia providers are exploring alternative adjuncts for labor epidurals. Dexmedetomidine, an alpha-2 adrenergic agonist with sedative and analgesic properties, has emerged as a potential non-opioid adjunct. Although widely used intravenously, its neuraxial use remains underutilized. Early studies suggest that dexmedetomidine offers effective pain control with fewer opioid-related side effects. However, concerns regarding maternal hemodynamic stability and limited long-term outcome data necessitate further evaluation.