Efficacy of Labour Analgesia with Standard Epidural versus Dural Puncture Epidural Techniques in Parturients – A Randomized Control Trial

Introduction: Neuraxial analgesia has a minimal risk of side effects and is very effective, making it the gold standard of labor analgesia. If the dural puncture epidural method (DPE) can validate midline implantation and increase intrathecal translocation of epidural medicines, it might enhance the quality of analgesia. The current research set out to evaluate the relative merits of standard epidural and dural puncture epidural approach for labor analgesia. Material and Methods: Sixty-four full term primi or multiparous parturients were randomly allocated to standard epidural technique (group 1, n=32) and dural puncture epidural technique (group 2, n=32) managed with dural puncture using 26-gauge Whitacre needle through the 18 G Tuohy needle. Visual analogue scale, hemodynamic variables, onset of analgesia, details of sensory and motor block by Bromage scale, and adverse events were noted and analysed. Results: The duration to achieve adequate analgesia was 12.02±1.98 in group 1 and 10.46±2.22 in group 2. Duration to achieve complete sacral spread was 17.18±4.89 in group 1 and 16.64±3.90 in group 2. VAS score <10 at 10 minutes was observed in 59.38% of cases in group 1 and 65.62% in group 2. Spontaneous vaginal deliveries are more common, and no significant changes in the hemodynamic parameters. Conclusion: Dural puncture epidural technique and standard epidural technique are efficacious, however, DPE improves sacral spread, fasten the onset of analgesia, and bilateral pain relief in parturients.