Single‐Shot Intrathecal Bupivacaine With Fentanyl vs. Dexmedetomidine for Labor Analgesia: A Randomized Controlled Trial

Background: Labor pain is one of the most intense physiological pains experienced by women. Single-shot spinal analgesia (SSSA) offers rapid and reliable labor pain relief. Combining bupivacaine with adjuvants like fentanyl or dexmedetomidine has been proposed to enhance analgesic efficacy and maternal comfort. Methods: In this randomized, double-blind clinical trial, 90 full-term parturients in active labor were randomly allocated into three equal groups: Group B: 2.5 mg intrathecal bupivacaine with 0.5 mL of saline; Group BF: 2.5 mg bupivacaine with 25 μg fentanyl; Group BD: 2.5 mg bupivacaine with 5 μg dexmedetomidine. We compared the duration and onset of analgesia, pain scores on the visual analog scale (VAS), maternal satisfaction using the short assessment of patient satisfaction (SAPS), adverse effects, and neonatal outcomes. Results: < 0.01). The incidence of itching and nausea was higher in the BF group, and mild bradycardia was found in the BD group. Apgar scores at 1 and 5 min were similar in all groups. Conclusion: ClinicalTrials.gov: NCT06823349.