ArticleJournal of anaesthesiology, clinical pharmacology
A randomized comparison of epidural, dural puncture epidural, and combined spinal-epidural without intrathecal opioids for labor analgesia.
Article in Journal of anaesthesiology, clinical pharmacology. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT03980951 (A Randomized Comparison of Epidural, Dural Puncture Epidural and Combined Spinal Epidural Without Intrathecal Opioids for Labor Analgesia.), which is not on this map. Cited by 8 papers, 3 of them syntheses that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
A Randomized Comparison of Epidural, Dural Puncture Epidural and Combined Spinal Epidural Without Intrathecal Opioids for Labor Analgesia.
Who cites it
8 citing papers in PubMed, 3 syntheses or guidelines pooled it, 22 citations in OpenAlex.
- Comparison of neuraxial anesthesia and analgesia strategies for obese parturients: a systematic review and network meta-analysis.BMC anesthesiology · 2026Pooled it
- Epidural analgesia versus dural puncture epidural analgesia in labouring parturients: a meta-analysis of randomised controlled trials.British journal of anaesthesia · 2025Pooled it
- Dural puncture epidural versus conventional epidural analgesia for labor: a systematic review and meta-analysis of randomized controlled studies.Journal of anesthesia · 2022Pooled it
- The Effectiveness and Safety of Dural Puncture Epidural for Aged Patients Undergoing Orthopedic Surgery: A Randomized Controlled Trial.Clinical interventions in aging · 2026Trial
- The significance of different intervertebral spaces in combined spinal epidural anesthesia in cesarean section.Technology and health care : official journal of the European Society for Engineering and Medicine · 2024Trial
- Dural Puncture Epidural with 25-G Spinal Needles versus Conventional Epidural Technique in Conjunction with PIEB for Labor Analgesia: A Randomized Trial.Journal of pain research · 2023Trial
- Application efficacy of dural puncture epidural versus traditional combined spinal epidural for labour analgesia: A systematic review and meta-analysis with trial sequential analysis.Indian journal of anaesthesia · 2025Article
- Dural puncture epidural technique provides better anesthesia quality in repeat cesarean delivery than epidural technique: Randomized controlled study.World journal of clinical cases · 2022Article
Corrections and comments
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Authors and funding
1 author at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
BACKGROUND AND
aimsDural puncture epidural (DPE) has been shown to improve labor analgesia over epidural (EPL), with fewer side effects than a combined spinal-epidural (CSE). However, there is some debate regarding the superiority of DPE over EPL and CSE. Therefore, we aimed to compare the effects of EPL, DPE, and CSE without intrathecal opioids on the epidural local anesthetic (LA) consumption and occurrence of side effects in early labor. MATERIAL AND
methodsWe randomly assigned parturient to one of the 3 groups; EPL, DPE, or CSE. EPL and DPE groups received a 10 mL loading dose of 0.1% bupivacaine with fentanyl 2 μg/mL. CSE group received intrathecal 2.5 mg bupivacaine (without opioids). Labor analgesia was maintained in all patients via patient-controlled epidural analgesia (PCEA). The primary outcome was the mean hourly consumption of epidural LA.
resultsThe mean hourly consumption of epidural LA anesthetic was significantly lower in CSE (9.55 mL), compared with the EPL (11 mL), and DPE (10.5 mL),
conclusionCompared with EPL and DPE, CSE without intrathecal opioids, had a less epidural LA consumption, faster onset of analgesia, with no difference in the incidence of side effects.
trial registrationThis study was registered at www.clinicaltrials.gov (NCT03980951).
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