{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,31]],"date-time":"2026-08-31T13:50:43Z","timestamp":1788184243346,"version":"build-2803163510"},"reference-count":70,"publisher":"MDPI AG","issue":"1","license":[{"start":{"date-parts":[[2026,3,18]],"date-time":"2026-03-18T00:00:00Z","timestamp":1773792000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Medical Sciences"],"abstract":"<jats:p>Effective pain management during labor must balance adequate maternal pain relief with preservation of maternal participation and fetal safety. Epidural anesthesia remains the gold standard for labor analgesia. However, commonly used local anesthetics and opioid adjuvants are associated with adverse effects that include nausea, pruritus, urinary retention, and prolonged labor. Dexmedetomidine, a highly selective \u03b12 agonist, does not carry the same risks for misuse and abuse as opioids do and may be a promising non-opioid adjuvant for epidural labor analgesia due to its analgesic, anxiolytic, and opioid-sparing properties. Furthermore, dexmedetomidine has unique pharmacodynamic effects, including preserving maternal consciousness while providing adequate analgesia. This combination of consciousness preservation and sufficient analgesia suggests dexmedetomidine may be a promising pharmaceutic for epidural anesthesia. In addition to preserving maternal consciousness, dexmedetomidine does not appear to cause a clinically significant increase in the motor blockade. Although epidural analgesia is known to prolong labor in nulliparous and multiparous patients, the use of dexmedetomidine as an epidural adjuvant does not have a significant effect on labor duration in available trials. Across studies, dexmedetomidine does not have deleterious outcomes for neonates, measured using the neonatal Apgar score. Although dexmedetomidine is not currently FDA-approved for epidural labor analgesia, existing evidence from available trials suggests its safety and efficacy as an opioid-sparing adjuvant. This narrative review aims to highlight the current state of knowledge of dexmedetomidine\u2019s pharmacology, efficacy, analgesic ability, and side effects.<\/jats:p>","DOI":"10.3390\/medsci14010144","type":"journal-article","created":{"date-parts":[[2026,3,18]],"date-time":"2026-03-18T10:11:12Z","timestamp":1773828672000},"page":"144","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Safety and Efficacy of Dexmedetomidine as an Adjuvant in Epidural Anesthesia for Labor Analgesia: A Narrative Review"],"prefix":"10.3390","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4687-147X","authenticated-orcid":false,"given":"Josephine M.","family":"Feeney","sequence":"first","affiliation":[{"name":"School of Medicine, Louisiana State University Health Sciences Center at Shreveport, Shreveport, LA 71103, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Seth J.","family":"Duet","sequence":"additional","affiliation":[{"name":"School of Medicine, Louisiana State University Health Sciences Center at Shreveport, Shreveport, LA 71103, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cailyn B.","family":"Jones","sequence":"additional","affiliation":[{"name":"School of Medicine, Louisiana State University Health Sciences Center at Shreveport, Shreveport, LA 71103, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anthony J.","family":"Baffi","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, Louisiana State University Health Sciences Center at Shreveport, Shreveport, LA 71103, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sandy","family":"Rayes Elmalakh","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, Louisiana State University Health Sciences Center at Shreveport, Shreveport, LA 71103, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kristin Nicole","family":"Bembenick","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, Louisiana State University Health Sciences Center at Shreveport, Shreveport, LA 71103, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-4545-4523","authenticated-orcid":false,"given":"Sahar","family":"Shekoohi","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, Louisiana State University Health Sciences Center at Shreveport, Shreveport, LA 71103, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shahab","family":"Ahmadzadeh","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, Louisiana State University Health Sciences Center at Shreveport, Shreveport, LA 71103, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,3,18]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"913","DOI":"10.1213\/ANE.0000000000007111","article-title":"Pioneering Patient-Centered Surgical Care and Anesthesia Practice: Hanaoka Seish\u016b\u2019s Contribution to Surgery During Japan\u2019s Isolationist Era","volume":"140","author":"Tanaka","year":"2025","journal-title":"Anesth. 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