Evidence map›Paper›PMID 40121178›Full record

SynthesisBritish journal of anaesthesia2025

Epidural analgesia versus dural puncture epidural analgesia in labouring parturients: a meta-analysis of randomised controlled trials.

Preet Mohinder Singh, David T Monks, Adithya D Bhat, Anuradha Borle, Manpreet Kaur, Phillip Yang, Muthuraj Kanakaraj

Erratum issuedAbstract readMeta-AnalysisComparative StudyReview
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in British journal of anaesthesia, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 9 papers.

0numbers the graph read from it
0cells of the map it votes in
9citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

9 citing papers in PubMed.

  1. Trial
  2. Trial
  3. Trial
  4. Trial
  5. Trial
  6. Article
  7. Article
  8. Article
  9. Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

7 authors.

Preet Mohinder SinghDepartment of Anaesthesiology, Washington University in Saint Louis/Barnes Jewish Hospital, Saint Louis, MO, USA. Electronic address: singh.p@wustl.edu.
David T MonksDepartment of Anaesthesiology, Washington University in Saint Louis/Barnes Jewish Hospital, Saint Louis, MO, USA.
Adithya D BhatDepartment of Anesthesiology, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.
Anuradha BorleDepartment of Anaesthesiology, Washington University in Saint Louis/Barnes Jewish Hospital, Saint Louis, MO, USA.
Manpreet KaurDepartment of Anaesthesiology, Hershey Medical Center, Penn State University, Hershey, PA, USA.
Phillip YangDepartment of Anaesthesiology, Washington University in Saint Louis/Barnes Jewish Hospital, Saint Louis, MO, USA.
Muthuraj KanakarajDepartment of Anaesthesiology, Washington University in Saint Louis/Barnes Jewish Hospital, Saint Louis, MO, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundEpidural analgesia and dural puncture epidural (DPE) analgesia are widely used techniques for alleviating labour pain. This meta-analysis compared clinical outcomes between parturients receiving epidural analgesia vs DPE analgesia for labour pain.

methodsMedical databases were searched to identify randomised controlled trials comparing epidural analgesia with DPE analgesia in labouring parturients published up to October 2024. Results were pooled using an inverse variance random-effects model, and 95% prediction intervals were calculated. Clinical outcomes were used as defined by individual trials. The primary outcome was time to onset of analgesia. Secondary outcomes were unilateral block, motor block, sacral sparing, adequate analgesia, Caesarean/operative vaginal delivery, additional doses, and hypotension. The certainty of evidence was assessed using Grading of Recommendations Assessment, Development, and Evaluation guidelines, and subgroup analyses were performed based on the types of local anaesthetics used.

resultsEighteen trials involving 2144 parturients were included. DPE labour analgesia slightly reduced the time to onset (mean difference: 3.4 min, 95% confidence interval: 2.1-4.7, P<0.01, I

conclusionsDPE labour analgesia offers a slightly faster onset and reduced incidence of motor and unilateral blocks compared with traditional epidural analgesia. However, high heterogeneity in some outcomes, likely attributable to clinical and dosing variability, requires cautious interpretation. Although the clinical relevance of the faster onset with DPE analgesia might be modest, when considered alongside its benefits in secondary outcomes it supports the use of DPE analgesia over traditional epidural analgesia. Imputed prediction intervals cross zero for many outcomes, and further studies might alter these findings. CLINICAL

trial registrationPROSPERO- CRD42024602115.

Indexed as

Analgesia, EpiduralAnalgesia, ObstetricalLabor PainSpinal PunctureFemaleHumansLabor, ObstetricPregnancyRandomized Controlled Trials as Topicdural puncture epidurallabour analgesialabour epiduralmeta-analysisunilateral labour analgesia

Identifiers

PMID40121178
PMCPMC12106887

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.