• Haiying Yin, Xin Tong, and Han Huang.
• Department of Anesthesiology, West China Second University Hospital, Key Laboratory of Birth Defects and Related Diseases of Women and Children, Sichuan University, Ministry of Education, 20#, 3rd Segment, Ren Min Nan Lu, Chengdu, 610041, People's Republic of China.
• J Anesth. 2022 Jun 1; 36 (3): 413-427.

AbstractDural puncture epidural (DPE) technique is a modification of the conventional epidural (EP) technique in that the dura is intentionally punctured with a spinal needle but without any spinal injection. This meta-analysis aimed to evaluate the benefits and risks associated with the DPE technique for labor analgesia. Randomized trials comparing DPE analgesia with EP analgesia for labor pain relief were systematically searched in the database of Medline, Embase, Cochrane Controlled Trials Register, Web of Science, and China Biology Medicine till 1st August 2021. The primary outcome was the percentage of patients with satisfactory pain relief following DPE or EP analgesia, which was defined as visual analog scale (VAS) pain scores ≤ 3/10 (or 30/100) measured 10 min and 20 min after initiation of labor analgesia. Totally ten trials with 1099 patients were included in this review. DPE technique increased the percentage of patients with VAS pain score ≤ 3/10 (or 30/100) both at 10 min (RR 1.43; 95% CI 1.17, 1.74; p < 0.001; I2 = 0%) and 20 min (RR 1.13; 95% CI 1.04, 1.22; p = 0.005; I2 = 0%) after labor analgesia. No adverse event was found with DPE analgesia. We conclude that compared with EP analgesia, DPE analgesia is beneficial for labor pain relief by shortening the time to achieve satisfactory pain control. Meanwhile, DPE analgesia is not associated with increased adverse maternal/fetal events.© 2022. The Author(s) under exclusive licence to Japanese Society of Anesthesiologists.

This article appears in the collection: Is dural-puncture epidural superior to standard epidural labour analgesia?.

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