compare the effect of intravenous and epidural dexmetomidine as an adjuvant to local anesthetics in epidural labor analgesia in normal labor
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Inclusion Criteria: * Full term (≥ 37 weeks) healthy primigravida parturients ASA2 * with single fetus scheduled for vaginal delivery * with cephalic presentation * requesting labor analgesia. Exclusion Criteria: * Allergy to dexmetomidine.(based on previous history) * Cardiac conduction abnormalities.(all degrees of heart block , tachyarrythmias) * Twins. * Malpresentation. * Preeclampsia or gestational hypertension * Uncontrolled diabetes HBA1c ≥ 6.5% * Uncontrolled renal failure * Uncontrolled liver disease * Bleeding tendency or coagulopathy. * Contraindication or patient refusal to epidural block. * Body mass index ≥ 35.