The goal of providing maternal labor analgesia is the relief of the suffering and pain of labor and delivery while minimizing effects on maternal safety, awareness, sensory and motor function, progress of labor, and fetal wellbeing. The primary goal is to provide adequate maternal analgesia with as little motor block as possible when regional analgesia is used for uncomplicated labor and/or vaginal delivery. Epidural analgesia is clearly the most effective form of pain relief in labor. Attention to minimization of motor blockade, combined with proper obstetric management should allow for a satisfactory low cesarean rate while also allowing patients to enjoy a pain free labor. The effects of ropivacaine alone and in adjuvant combination with fentanyl, tramadol, ketamine and clonidine for continuous epidural labor analgesia as regards to their sensory, motor and hemodynmic effects.