Epidural Technique: Does it Really Matter to the Patient?

Dural Puncture Epidural Technique vs. Standard Epidurals vs. Combined-Spinal Epidurals for Cesarean Sections: Does it Really Matter to the Patient?

The main objective of this study will be to determine if the dural puncture epidural (DPE) provides superior analgesia and better patient satisfaction when compared to traditional epidurals for cesarean sections, and to also determine if patient satisfaction in the DPE group is comparable to that of the CSE technique.

There are approximately 4 million child birth deliveries in US hospitals per year, and 1.3million of those births are via cesarean section (c-section). With this type of surgery, obstetric anesthesiology plays an important role. The main objective of this study will be to determine if the dural puncture epidural (DPE) provides superior analgesia and better patient satisfaction when compared to traditional epidurals for cesarean sections, and to also determine if patient satisfaction in the DPE group is comparable to that of the CSE technique.

Inclusion Criteria:

• Female parturient at Grady Memorial Hospital must meet one of the following:
• Parturient having a scheduled or elective cesarean section
• Parturient not having primary cesarean-section
• At least 18 years of age
• Subject has signed the informed consent

Exclusion Criteria:

• Parturient who is unable or unwilling to sign the consent form
• Parturient having primary cesarean section
• Parturient with known complex cardiac disease (ex…aortic/mitral stenosis, aortic aneurysms, congenital heart disease with residual defects…etc)
• Parturient with any contraindication to neuraxial anesthesia such as coagulopathy, infection, or patient refusal
• Parturient having a fourth or more cesarean section