Abstract
(Int J Obstet Anesth. 2020;42:26–33) Opioids are a common epidural adjuvant for top-up boluses with local anesthetic for labor analgesia. There has been increased interest in nonopioid options in recent years as opioid-use disorder has become more prevalent. Clonidine, a lipophilic α2-adrenergic agonist, has been used for initiation and maintenance of labor analgesia in patients with opioid tolerance but has not been studied as an adjuvant for breakthrough pain in labor. This study aimed to compare clonidine and bupivacaine to fentanyl and bupivacaine in terms of efficacy for breakthrough labor pain, hypothesizing that clonidine would be superior to fentanyl.
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