Treatment of breakthrough labor pain with epidural dexmedetomidine: a case series

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.