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How neuraxial labor analgesia differs by approach: dural puncture epidural as a novel option


Background and aim

Neuraxial analgesia techniques are not limited to just standard epidural and CSE blocks. A novel approach called dural puncture epidural (DPE) which is a modification of CSE in terms of practice has gained popularity after its description and use in the obstetric population.  The aim of this review is to address the practice of DPE technique as a novel option by reviewing its benefits as well as side and/or adverse effects and to understand how neuraxial labor analgesia differs by approach based on the information available in the current literature


Despite controversies and concerns, more rapid onset of analgesia, early bilateral sacral analgesia, lower incidence of asymmetric block and fewer maternal and fetal side effects are provided with DPE when compared to epidural.


DPE offers a favorable risk–benefit ratio for management of neuraxial analgesia as a novel option.

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Correspondence to Berrin Gunaydin.

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Gunaydin, B., Erel, S. How neuraxial labor analgesia differs by approach: dural puncture epidural as a novel option. J Anesth 33, 125–130 (2019).

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  • Labor pain
  • Neuraxial analgesia
  • Dural puncture epidural
  • Epidural
  • Combined spinal epidural