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Author Spotlight: Enhancing Success of Ultrasound-Guided Neuraxial Anesthesia in Cases with Difficult Anatomy
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Treatment of breakthrough labor pain with epidural dexmedetomidine: a case series

Abigail Blanton1, Zehra Tombul1, Robert Beck2

  • 1University of Texas Southwestern Medical School, Dallas, Texas, USA.

Proceedings (Baylor University. Medical Center)
|March 16, 2026
PubMed

Breakthrough labor pain, defined as the return of pain despite ongoing administration of neuraxial analgesia, poses a significant challenge within the field of obstetric anesthesia. Epidural adjunct medications may be used to enhance neuraxial block density or provide coverage to previously spared regions. Dexmedetomidine, a US Food and Drug Administration-approved selective alpha-2 adrenergic agonist, has gained attention for an off-label use as a labor epidural adjunct medication for labor analgesia. This case series highlights three cases of epidural dexmedetomidine use for breakthrough pain during labor.

Keywords:
Dexmedetomidineepidural analgesialabor painobstetrical anesthesia

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