Dural Puncture Epidural Technique is modification on CSE technique.

Dural perforation created using spinal needle but no intrathecal medication given.
DPE technique shown to improve caudal spread of analgesia compared with epidural technique, without side effects of CSE technique.

RCT of 120 healthy women in early labour
  • DPE had earlier and greater incidence of sacral coverage
  • Less incidence of asymmetric blockade and physician top-up interventions
Other literature of technique suggests size of spinal needle important.


Chau, Anthony; Bibbo, Carolina; Huang, Chuan-Chin; Elterman, Kelly G.; Cappiello, Eric C.; Robinson, Julian N.; Tsen, Lawrence C. Dural Puncture Epidural Technique Improves Labor Analgesia Quality With Fewer Side Effects Compared With Epidural and Combined Spinal Epidural TechniquesAnesthesia & Analgesia: Vol. 124 Issue 2 – 2017: 560 – 569.
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