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

Best Pract Res Clin Anaesthesiol. 2022 May;36(1):31-36. doi: 10.1016/j.bpa.2022.04.006. Epub 2022 Apr 29.


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.

Publication types

  • Review

MeSH terms

  • Analgesia, Epidural* / methods
  • Analgesia, Obstetrical* / methods
  • Analgesics
  • Analgesics, Opioid
  • Anesthetics, Local
  • Female
  • Humans
  • Labor, Obstetric*
  • Pain Measurement
  • Pregnancy


  • Analgesics
  • Analgesics, Opioid
  • Anesthetics, Local