Randomized Controlled Trial
Copyright ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Jul 16, 2022; 10(20): 6890-6899
Published online Jul 16, 2022. doi: 10.12998/wjcc.v10.i20.6890
Dural puncture epidural technique provides better anesthesia quality in repeat cesarean delivery than epidural technique: Randomized controlled study
Sheng-You Wang, Yan He, Hai-Juan Zhu, Bo Han
Sheng-You Wang, Hai-Juan Zhu, Bo Han, Department of Anesthesiology, Hefei Maternal and Child Health Care Hospital, Hefei 230001, Anhui Province, China
Sheng-You Wang, Hai-Juan Zhu, Bo Han, Department of Anesthesiology, Maternal and Child Health Care Hospital of Anhui Medical University, Hefei 230001, Anhui Province, China
Yan He, Department of Anesthesiology, Wannan Medical College, Wuhu 241002, Anhui Province, China
Author contributions: Wang SY was responsible for the study design, data collection, and manuscript drafting; He Y and Zhu HJ were responsible for data collection and analysis; Han B reviewed and revised the article; all the authors reviewed and approved the final version to be published.
Supported by the Applied Medical Research Project of Hefei Health and Family Planning Commission, No. Hwk2020yb0016.
Institutional review board statement: The study was reviewed and approved by the Institutional Ethics Committee of the Anhui Women and Child Health Care Hospital, No. YYLL2020-15-01.
Clinical trial registration statement: This study is registered prior to subject enrollment at www.chictr.org.cn. The registration identification number is ChiCTR2100050266.
Informed consent statement: All study participants, or their legal guardian, provided informed written consent prior to study enrollment.
Conflict-of-interest statement: The authors declare that they have no conflict of interest.
Data sharing statement: The data that support the findings of this study are available from the corresponding author upon request.
CONSORT 2010 statement: The authors have read the CONSORT 2010 Statement, and the manuscript was prepared and revised according to the CONSORT 2010 Statement.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Bo Han, MD, Chief Doctor, Department of Anaesthesiology, Anhui Maternal and Child Health Care Hospital, No. 15 Yimin Street, Hefei 230001, Anhui Province, China. 454379626@qq.com
Received: November 23, 2021
Peer-review started: November 23, 2021
First decision: January 22, 2022
Revised: February 3, 2022
Accepted: May 16, 2022
Article in press: May 16, 2022
Published online: July 16, 2022
ARTICLE HIGHLIGHTS
Research background

Repeat cesarean delivery (RCD) involves a longer surgery and more severe visceral traction than primary cesarean deliverys, and the rate of RCD is increasing year by year. As an improvement upon the combined spinal-epidural (CSE) technique, the dural puncture epidural (DPE) technique has been reported to provide faster and more effective labor analgesia; however, insufficient data from among parturients undergoing RCD were available. This study aimed to determine whether the DPE technique is superior to the epidural anesthesia (EA) technique in parturients undergoing repeat cesarean Delivery.

Research motivation

The aim of this study was to overcome the drawbacks of the slow onset and limited blockade spread of the EA technique. The DPE technique might provide a faster onset and better spread than the EA technique while providing more stable hemodynamics than the CSE technique; hence, this technique might be superior to the EA and CSE techniques.

Research objectives

The objective of this study was to find a better anesthesia method for repeat cesarean delivery.

Research methods

This was a double-blind, prospective, randomized controlled trial.

Research results

The DPE technique provided a faster onset of surgical anesthesia, better cranial and sacral sensory spread and higher motor block degree without increasing the incidence of maternal or fetal side effects when compared with the EA technique in patients undergoing RCD.

Research conclusions

The DPE technique provided higher-quality anesthesia than the EA technique when used in patients undergoing repeat cesarean delivery.

Research perspectives

Future research will explore the short-term and long-term potential complications of the DPE technique.