TDNet Discover

Introduction: Since the early 1920s, neuraxial analgesia and anesthesia have played an integral role in labor pain management, evolving significantly in technique and effectiveness. The “single-shot” lumbar epidural technique was first developed in 1921 by Fidel Pagés, a Spanish military surgeon. In 1931, Eugen Aubrel, a Romanian obstetrician, further advanced labor analgesia management by introducing the epidural catheter technique, in which local anesthetic is continuously delivered. Decades later, in 1979, M. Behar et al. reported the first use of opioids as adjuncts in neuraxial anesthesia. Opioids enhance labor analgesia by providing longer and more effective pain relief than local anesthetics alone. However, their use is associated with maternal side effects, such as pruritus, hypotension, and respiratory depression, along with fetal complications like reduced Apgar scores, bradycardia, and respiratory depression. Although neuraxial labor analgesia has come a long way since its inception, the complications associated with opioid use have driven researchers to explore alternative options for safer and more effective pain management. Since its introduction in 1999, dexmedetomidine emerges as a promising adjunct in labor analgesia. Clinicians and researchers have investigated its neuraxial administration to reduce opioid-related side effects while maintaining or improving analgesic effectiveness. This analysis aims to compare the use of dexmedetomidine with lipophilic opioids in labor epidural analgesia, evaluating its impact on pain management and its potential as a more effective medication to enhance pain management for the laboring parturient.