Intrathecal Dexmedetomidine as an adjunct for Labour Analgesia: A Systematic review

IntroductionLabor pain is one of the most painful experiences that women encounter during child birth that affect fetal and maternal wellbeing. Therefore providing labor analgesia is an essential part of maternity care for laboring mother. Intrathecal dexmedetomidine has emerged as a promising option for labor analgesia adjunct with probable less side effects than opioids in recent years. The aim of this review is to systematically review the current literature on the efficacy, safety and side effect profile of intrathecal Dexmedetomidine as a non-opioid option adjunct for labour epidural analgesia. MethodsThis systematic literature review is reported using the Preferred Reporting of Systematic Review and Meta-Analysis protocol. The search aimed to identify articles published in the English language that discussed the efficacy of intrathecal Dexmedetomidine for combined spinal epidural or intrathecal labor analgesia that published before February 2023. To explore relevant and related articles related to our research question (PICO question), we utilized various search engines including Google Scholar, PubMed/Medline, the Cochrane Library, and conducted manual searches. ResultThe search strategy retrieved 38 articles from various electronic databases and after removing duplicates by Endnote 20 version and 32 articles were selected for screening; finally, nine articles were included for systematic review and critical appraisal. ConclusionThis review indicates that compared to opioids intrathecal administration of Dexmedetomidine for labor analgesia provides potent analgesic efficacy, improving the duration, intensity, and quality of the block, reducing the need for opioids and minimizing opioid related adverse effects for both mothers and neonates.