15: Is dural puncture epidural (DPE) the optimal labor analgesia technique?
Release Date: 07/03/2020
Depth of Anesthesia
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Dr. Chris Di Capua and Dr. Bryan Glezerson (@BryanGlezerson) join the show to discuss the literature around the risk of aspiration with LMAs compared to ETTs. This is part I of a two-part series on LMAs. In part II, we discuss the safety of LMAs in specific patient populations including patients receiving positive pressure ventilation, patients undergoing laparoscopic surgery, obese patients, and pregnant patients. This is an episode produced from the Depth of Anesthesia Podcast Elective that’s available to MGH anesthesia residents. Special thanks to Dr. Saddawi-Konefka for supporting the...
info_outlineIn this episode, we investigate the following claims related to DPE:
1. Dural puncture epidural (DPE) technique improves analgesic quality versus traditional epidural
2. DPE technique has faster onset of analgesia versus traditional epidural
3. DPE has less adverse effects compared with combined spinal-epidural (CSE)
Our guest today is Dr. Ronald George (@Ron_George), Professor and Chief of Obstetric Anesthesia at UCSF.
Connect with us @DepthAnesthesia on Twitter or email us at [email protected]
Thanks for listening! Please rate us on iTunes and share with your colleagues.
Music by Stephen Campbell, MD.
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References
Heesen M, Rijs K, Rossaint R, Klimek M. Dural puncture epidural versus conventional epidural block for labor analgesia: a systematic review of randomized controlled trials. Int J Obstet Anesth. 2019;40:24-31. doi:10.1016/j.ijoa.2019.05.007
Thomas JA, Pan PH, Harris LC, Owen MD, D'Angelo R. Dural puncture with a 27-gauge Whitacre needle as part of a combined spinal-epidural technique does not improve labor epidural catheter function. Anesthesiology. 2005;103(5):1046-1051. doi:10.1097/00000542-200511000-00019
Wilson SH, Wolf BJ, Bingham K, et al. Labor Analgesia Onset With Dural Puncture Epidural Versus Traditional Epidural Using a 26-Gauge Whitacre Needle and 0.125% Bupivacaine Bolus: A Randomized Clinical Trial. Anesth Analg. 2018;126(2):545-551. doi:10.1213/ANE.0000000000002129
Cappiello E, O'Rourke N, Segal S, Tsen LC. A randomized trial of dural puncture epidural technique compared with the standard epidural technique for labor analgesia. Anesth Analg. 2008;107(5):1646-1651. doi:10.1213/ane.0b013e318184ec14
Chau A, Bibbo C, Huang CC, et al. Dural Puncture Epidural Technique Improves Labor Analgesia Quality With Fewer Side Effects Compared With Epidural and Combined Spinal Epidural Techniques: A Randomized Clinical Trial. Anesth Analg. 2017;124(2):560-569. doi:10.1213/ANE.0000000000001798
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