Abstract
Background: The dural puncture epidural technique could provide better haemodynamic stability in elective caesarean delivery compared with spinal anaesthesia. We aimed to investigate if the dural puncture epidural technique could reduce the incidence of hypotension in elective caesarean delivery compared with spinal anaesthesia.
Methods: This was a single-centre, parallel-group, randomised, double-blind controlled trial at the Yichang Central People’s Hospital. Healthy women aged 20–40 years with an American Society of Anesthesiologists grade I or II, undergoing elective primary caesarean delivery, and with foetuses with vertex presentation at 38–40 weeks of gestation were enrolled. The patients were randomised into group S (spinal anaesthesia) and group D (dural puncture epidural technique) with different neuraxial placement. The primary outcome was the incidence of hypotension during the operation. The secondary outcomes were time from injection to the end of operation, average dose of rescue ephedrine, incidence of intraoperative nausea and vomiting, heart rate, neonatal umbilical vein pH, and Apgar scores at 1 and 5 min.
Results: The findings of our study revealed that the dural puncture epidural technique reduces the incidence of hypotension in caesarean delivery compared with spinal anaesthesia, without affecting heart rate. There was no significant difference in the onset time from injection to the end of operation, and no severe adverse effects were found in our study.
Conclusions: The dural puncture epidural technique could provide better haemodynamic stability when the risks and benefits to the mother and her foetus are considered together.
Trial registration: The trial was registered on October 30, 2021 at www.chictr.org.cn (ChiCTR2100052541).