Dural Puncture Epidural vs Standard Epidural Analgesia in Labor
A Randomized Prospective Trial Comparing Dural Puncture Epidural (DPE) and Standard Epidural Analgesia for Labor in Term Pregnant Women"
Saglik Bilimleri Universitesi Gazi Yasargil Training and Research Hospital
102 participants
Jan 20, 2026
INTERVENTIONAL
Conditions
Summary
This randomized prospective study compares Dural Puncture Epidural (DPE) and Standard Epidural Analgesia in term laboring women. The study evaluates analgesic quality, onset time, maternal and neonatal outcomes, side effects, and overall patient satisfaction.
Eligibility
Inclusion Criteria8
- Term pregnant women (≥37 weeks of gestation).
- Requesting neuraxial labor analgesia.
- Age between 18 and 45 years.
- ASA physical status I-II.
- Cervical dilation ≥ 4 cm at the time of enrollment.
- Cervical effacement ≥ 50-60%.
- Baseline pain score of VAS ≥ 3.
- Ability to provide informed consent.
Exclusion Criteria12
- Hypertensive disorders of pregnancy (gestational hypertension, preeclampsia, eclampsia).
- Placental abnormalities (placenta previa, placental abruption, etc.).
- Contraindications to neuraxial anesthesia (coagulopathy, infection at puncture site, severe hypovolemia).
- Known allergy or hypersensitivity to local anesthetics or opioids used in the study.
- Morbid obesity (Body Mass Index ≥ 40 kg/m²).
- Opioid dependence or chronic opioid use.
- Accidental dural puncture with the epidural needle prior to randomization.
- Multiple gestation or non-cephalic presentation (if clinically relevant to your protocol).
- Fetal distress at the time of enrollment.
- Patient refusal to participate.
- Any condition deemed by the investigator to pose increased risk or interfere with study outcomes.
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Interventions
The Dural Puncture Epidural (DPE) technique is performed by inserting a 27-gauge Whitacre spinal needle through the Tuohy epidural needle to puncture the dura without intrathecal drug injection. After removal of the spinal needle, an epidural catheter is placed, and following a negative test dose, a bolus of 10 mL 0.125% bupivacaine with 1.5 µg/mL fentanyl is administered.
Standard Epidural Analgesia is performed using a Tuohy needle without dural puncture. An epidural catheter is inserted into the epidural space, and after a negative test dose, a bolus of 10 mL 0.125% bupivacaine with 1.5 µg/mL fentanyl is administered.
Locations(1)
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NCT07278895