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Dural Puncture Epidural (DPE) Technique: Efficacy and Safety Overview.

Who can join

Ages 18 and older · Women

Inclusion Criteria:

* o Women with a single vertex presentation fetus at term (37-42 weeks) with intact fetal membranes or membrane rupture \<6 hours previously, who request to have an epidural for labor analgesia and provide written consent for the study.

Exclusion Criteria:

* o Patients being treated/managed for chronic pain.

  * Allergies or significant adverse reactions to local anesthetic or opioid medications
  * Contraindication to labor epidural placement
  * Patients with history of spine abnormalities or spine surgery.
  * Prisoners
  * Clinical signs or symptoms of infection.
  * Non-English speakers.

About the study

Neuraxial techniques such as lumbar epidural and combined spinal-epidural (CSE) are the most effective methods for labor analgesia and are associated with high patient satisfaction. However, standard epidurals can have failure rates and may be difficult to reliably confirm correct placement.

The dural puncture epidural (DPE) technique has been introduced to improve confirmation of epidural placement and potentially enhance analgesia. It involves identifying the epidural space, puncturing the dura with a spinal needle without injecting medication, confirming cerebrospinal fluid flow, and then placing the epidural catheter. While DPE may improve analgesia and drug spread, current evidence is limited and does not clearly demonstrate superiority over standard epidural techniques.

At The Ohio State Wexner Medical Center, DPE is used routinely for labor epidurals. This observational study evaluates epidural failure rates and anesthesia provider confidence in performing DPE, while also collecting procedural details, patient characteristics, analgesic outcomes, and complications. Provider confidence is assessed using a 3-point scale along with factors influencing performance, and patient outcomes include pain relief, need for rescue dosing, and overall epidural effectiveness.

What is being tested

• Dural Puncture Epidural (DPE) Technique (procedure)

Sponsor: Ohio State University · Participants: 150 · Started: Oct 1, 2024

Contact the study team

• Goran Ristev · Phone: 6142938487

Official record on ClinicalTrials.gov — NCT07704554

Locations in the U.S.

From ClinicalTrials.gov, data retrieved Sep 30, 2026. Each study sets its own eligibility; the study team decides who can join.