Dural Puncture Epidural Versus Combined Spinal Epidural With Epidural Volume Extension in Labor Analgesia
Summary
Labor is the process where the cervix is prepared to allow the baby to pass from the uterine cavity to the outside world. In the ordinary course, it ends with spontaneous or instrumental vaginal delivery or cesarean section. Traditionally, the first stage in which the cervix is passively dilated in response to uterine contractions consists of the second stage in which the mother passes the baby through the vagina and the third stage, the exit of the placenta. In the first stage of labor, pain is caused by uterine contractions and pressure on the cervix. Pain is transmitted through the T10-L2 spinal nerves and is felt in the abdominal wall, waist, hips, or thighs. In the second stage, pain from the vagina and perineum is added to uterine pain. This pain is transmitted by the pudendal nerves through the S2-4 nerve roots. In this study, we aimed to investigate the effects of dural puncture epidural analgesia versus combined spinal-epidural analgesia with epidural volume extension on labor variables.
Timeline
- Start
- 2020-02-01
- Primary completion
- 2021-02-01
- Completion
- 2021-02-07
Publications
- Background Contreras F, Morales J, Bravo D, Layera S, Jara A, Riano C, Pizarro R, De La Fuente N, Aliste J, Finlayson RJ, Tran DQ. Dural puncture epidural analgesia for labor: a randomized comparison between 25-gauge and 27-gauge pencil point spinal needles. Reg Anesth Pain Med. 2019 May 22:rapm-2019-100608. doi: 10.1136/rapm-2019-100608. Online ahead of print.
- Background Chau A, Bibbo C, Huang CC, Elterman KG, Cappiello EC, Robinson JN, Tsen LC. Dural Puncture Epidural Technique Improves Labor Analgesia Quality With Fewer Side Effects Compared With Epidural and Combined Spinal Epidural Techniques: A Randomized Clinical Trial. Anesth Analg. 2017 Feb;124(2):560-569. doi: 10.1213/ANE.0000000000001798.
- Doymus O, Aydin ME, Bedir Z, Tor IH, Ejder Tekgunduz S, Doymus G, Celik EC, Ahiskalioglu A. Epidural volume extension versus dural puncture epidural analgesia for labor: A prospective randomized study. Medicine (Baltimore). 2025 Mar 7;104(10):e41691. doi: 10.1097/MD.0000000000041691.
Drugs
| Evaluation | Drug | Modality | Dose | Route |
|---|---|---|---|---|
| Comparator | Bupivacaine | Other / unclassified | 0.125 % | Other |
| Comparator | Bupivacaine | Other / unclassified | 0.25 % | Other |
| Comparator | Bupivacaine | Other / unclassified | 2 mg | Other |
| Comparator | Fentanyl | Other / unclassified | 2 ug/ml | Other |
| Comparator | Fentanyl | Other / unclassified | 10 ug | Other |
Indications
No indication recorded.