Epidural vs. Dural Puncture Epidural in Labor Analgesia

Childbirth is an intense physical and psychological experience. Epidural analgesia (EP) remains the gold standard in labor pain management. However, continuous refinements are aimed at enhancing analgesic quality and mitigating adverse effects. In recent years, the dural puncture epidural (DPE) technique has gained popularity. In this technique, the dura is intentionally punctured with a spinal needle before the epidural catheter is placed, but no intrathecal medication is administered. This historically controlled study evaluates the clinical outcomes of a protocol transition from standard high-dose epidural to low-dose DPE. The primary objective is to compare total analgesic consumption and success rates of labor analgesia between the two techniques. The secondary objectives include the assessment of hemodynamic parameters, motor block characteristics, adverse effects (such as paresthesia and hypotension), and overall maternal satisfaction

Inclusion Criteria: * American Society of Anesthesiologists (ASA) physical status I-II * Gestational age 37-42 weeks * Planned vaginal delivery * Request for labor analgesia during active labor with cervical dilation ≥ 4 cm Exclusion Criteria: * Multiple gestations * Diagnosis of preeclampsia/eclampsia * Severe systemic disease * Contraindications to epidural analgesia (e.g., coagulopathy, infection at the injection site) * History of opioid dependence * Refusal to participate in the study protocol * Missing data in medical records for the retrospective group