Effect of Dural-Puncture Epidural vs Standard Epidural for Epidural Extension on Onset Time of Surgical Anesthesia in Elective Cesarean Delivery: A Randomized Clinical Trial
Authors' conclusion
Anesthesia initiated following a DPE technique resulted in faster onset and improved block quality during epidural extension compared with initiation with a standard epidural technique.
Study context
- Population
- Women aged ≥18 years with a singleton pregnancy undergoing scheduled cesarean delivery, tertiary care university hospital
- Participants
- 140 women
- Comparison
- Dural-puncture epidural vs standard epidural for epidural extension
- Dural-puncture epidural (DPE)n = 70
- Standard epiduraln = 70reference
- Primary endpoint
- Time from chloroprocaine administration to surgical anesthesia (T6 sensory block)
Methodological detailsdouble-blind, single-centre
- Double-blind
- Single-centre
Primary result
Onset time to surgical anesthesia
Median difference
233 seconds
CI 104–369
By group
DPE vs Standard epidural
median difference 233 seconds (CI 104–369)
As reported in the abstract
Secondary outcomes
| Outcome | DPE | Standard epidural | OR (95% CI) | P value | |
|---|---|---|---|---|---|
| Composite of lower quality anesthesia | 15.7% | 36.3% | 0.33 (0.14–0.74) | P = 0.007 | |
| 0.10.31310Odds ratio (log scale) |
- Composite of lower quality anesthesia: 24 of 66 women in standard epidural
Original publication
Effect of Dural-Puncture Epidural vs Standard Epidural for Epidural Extension on Onset Time of Surgical Anesthesia in Elective Cesarean Delivery: A Randomized Clinical Trial. JAMA Netw Open. Published 1 August 2023. doi:10.
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