Abstract: Objective To evaluate the analgesia onset , block quality and side effects of dural puncture epidural technique for labor analgesia. Methods 662 primiparas with singleton, vertex presentation fetuses at 38 to 42 weeks’ gestation with spontaneous parturiton were selected. All patients were randomly divided into 3 groups: Combined spinal epidural group (CSE group), Dural puncture epidural(DPE group)and epidural group (EP group).In the first 20 minutes, numerical rating scale(NRS) score was recorded every 2 minutes to determine the time to reach NRS≤1,and this was the main outcome; Secondary outcomes included the verbal numeric pain rating scale(NPR),block quality,maternal side effects,uterine contractions patterns, changes of the fetal heart rate in the first and second stages of labor.The neonatal Apgar score was recored. Results The time of group C achieved NPR≤1 was shorter than group D and group D was shorter than group E(P0.05).The median times (interquartile range) to NPRS≤1 were 2 (2–6) minutes for CSE, 10 (6–12) minutes for DPE, and 12 (10–18) minutes for EP.Compared with group E, the numerical rating scale(NRS2) when the uterine neck whole opened, the incidence of bilateral S2 block, asymmetric block,and doctors' supplementary intervention were significantly lower at 20 minutes in group D(P0.05). Compared with group C, the incidence of Bromage score≥1, pruritus, hypotension, uterine contraction, the deceleration of fetal heart rate and doctor's supplementary intervention were significantly reduced in group D(P0.05). Conclusion Dural puncture epidural technique has rapid analgesia, better analgesic effect, and lower incidence of side effects. It is a safe and effective technique for labor analgesia.
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