Post-dural Puncture Headache in Dural Puncture Epidural and Combined Spinal-Epidural Using 24- and 25-Gauge Needles Versus Conventional Epidural Labor Analgesia: A Systematic Review and Meta-analysis
Authors' conclusion
Headache was a rare event in both groups.
Study context
- Population
- Parturients receiving labor analgesia
- Participants
- 3,278 participants · 16 randomized controlled trials (RCTs)
- Comparison
- CSE/dural puncture epidural (DPE) vs Epidural
- CSE/DPEn = 1,513
- Epiduraln = 1,765reference
- Outcome
- Headache
Methodological detailsBayesian estimation, risk-of-bias 2 tool
- Bayesian estimation
- Risk-of-bias 2 tool
Pooled result
As reported in the abstract
Headache
Denominator CSE/DPE 1513 · Epidural 1765
Headache rate
- Posterior log OR of treatment effect (θ) favoured the control group (fewer events); events rare, 95% CrI wide (−0.49 to 1.22)
- 0.35
Further pooled results
Headache in 10 of 16 RCTs
- No patients of 1428 reported a headache
- 0%
- 95% CrI 0.00-0.25
Original publication
Post-dural Puncture Headache in Dural Puncture Epidural and Combined Spinal-Epidural Using 24- and 25-Gauge Needles Versus Conventional Epidural Labor Analgesia: A Systematic Review and Meta-analysis. Anesth Analg. Published 19 May 2026. doi:10.
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