1. Introduction
Neuraxial labor, neuraxial labor, labor, labor pain
COMPLICATIONS; ANESTHESIA, SECONDARY, CONTRACTION, COMPLICATIONS
This study aimed to investigate the effect of dural puncture epidural (DPE) combined with small-dose lidocaine for labor analgesia. Parturients were randomly divided into epidural anesthesia (EA), DPE1, and DPE2 groups. In the EA group, 5 mL of 1% lidocaine was administered via conventional L2–L3 puncture catheterization; in the DPE1 group, epidural drug was administered after catheterization using the DPE technique; in the DPE2 group, epidural puncture drug was administered through the epidural puncture needle before catheterization using the DPE technique. The primary outcome was the onset time of analgesia. The secondary outcomes included the numerical rating scale (NRS) scores during uterine contraction before bolus injection of experimental dose (T0) and the second time (T1), the fifth time (T2) and the tenth time (T3) after bolus injection of experimental dose; NRS scores at the second stage of labor (T4) and during perineal suture (T5); operation time of anesthesia; puncture related complications; anesthesia related complications; delivery outcome; use of local anesthesia during vaginal suture; and Apgar score of the neonates. There were 115 women included. The onset time in the DPE2 group was markedly shorter than in the EA and DPE1 groups (Neuraxial analgesia is the first choice for labor analgesia because of its definite analgesic effect and high maternal and child safety. Neuraxial labor analgesia can not only effectively relieve labor pain but also provide quick and favorable anesthetic effect for instrumental delivery or conversion to cesarean section during labor. The techniques used for neuraxial labor analgesia include epidural analgesia (EA), combined spinal–epidural anesthesia (CSEA), and single-shot spinal anesthesia. Although CSEA for labor has shorter onset time and is more effective than simple EA,Dural puncture epidural (DPE) is a special technique in which a spinal needle is used to puncture the dura mater and then withdrawn; but no drug is delivered into the subarachnoid space.