Neuraxial labor analgesia: is there a place for neuraxial adjuvants beyond opioids

Abstract

Neuraxial labor analgesia is considered the gold standard technique for analgesia. Ideally, a good neuraxial technique uses dilute local anesthetic solutions to produce effective pain relief with no or minimal motor impairment. Adjuvant drugs that are co-administered with the local anesthetic either epidurally or intrathecally are useful in achieving this goal. The current review focuses on the effectivity and side-effect profile of various commonly used or tested adjuvants.

Keywords: clonidine; dexmedetomidine; epidural fentanyl; epidural sufentanil; fetal heart rate abnormalities; intrathecal; neostigmine.