Department of Anesthesiology and Reanimation, Gazi University School of Medicine, Besevler, 06500, Ankara, Turkey.
J Anesth. 2019 Feb;33(1):125-130. doi: 10.1007/s00540-018-2564-y. Epub 2018 Oct 6.
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 DISCUSSION: 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.
神经轴镇痛技术不仅限于标准的硬膜外和 CSE 阻滞。一种新的方法,即硬膜穿刺硬膜外(DPE),是 CSE 在实践中的一种改良,在其描述和在产科人群中的应用后,已变得流行。本综述的目的是通过回顾其益处以及副作用和/或不良反应来讨论 DPE 技术作为一种新选择的实践,并根据现有文献中的信息了解不同方法的椎管内分娩镇痛有何不同。讨论:尽管存在争议和担忧,但与硬膜外相比,DPE 具有更快的镇痛起效时间、更早的双侧骶骨镇痛、更低的不对称阻滞发生率以及更少的母婴副作用。结论:DPE 为神经轴镇痛管理提供了有利的风险效益比,是一种新的选择。