Conversion of Labor Analgesia for Intrapartum Cesarean Delivery: DPE v CSE v Epidural

NCT05514431 | Enrolling By Invitation

• 1 other identifier: 20-004677
• Study Type: observational
• Target: 1,500
• Locations: 2 countries
• Sites: 2

Brief Summary

As the dural puncture epidural (DPE) is increasing in popularity for labor analgesia, it is important to understand how it impacts outcomes in parturients. Prior studies have found epidural catheters placed via the combined-spinal epidural technique have greater success at surgical conversion for cesarean delivery than catheters placed via traditional techniques. The investigators aim to determine if epidural catheters placed by a DPE technique will also have an increased successful conversion for surgical anesthesia by conducting a retrospective review of all CD during the study period. If an association is found, this could be another benefit of DPE for labor analgesia.

Conditions

Anesthesia; Analgesia

Keywords

epidural; cesarean; parturient

Outcome Measures

Primary Outcomes (1)

• Conversion to surgical anesthesia

  Number of subject to have success of conversion to surgical anesthesia for intrapartum cesarean delivery

  Baseline

Study Arms (3)

Dural puncture epidural (DPE)

Subjects that received neuraxial labor analgesia of dural puncture epidural for intrapartum cesarean delivery

Procedure: Dural Puncture Epidural (DPE) technique

Combined spinal epidural (CSE)

Subjects that received neuraxial labor analgesia of combined spinal epidural for intrapartum cesarean delivery

Procedure: Combined Spinal-Epidural (CSE) technique

Traditional Epidural

Subjects that received neuraxial labor analgesia of epidural for intrapartum cesarean delivery

Procedure: Epidural

Interventions

Epidural PROCEDURE

Traditional epidural catheter placement

Traditional Epidural

Dural Puncture Epidural (DPE) technique PROCEDURE

Epidural catheters placed via DPE technique

Dural puncture epidural (DPE)

Combined Spinal-Epidural (CSE) technique PROCEDURE

Epidural catheters placed via CSE technique

Combined spinal epidural (CSE)

Eligibility Criteria

• Sex: female
• Healthy Volunteers: Yes
• Age Groups: Child (0-17), Adult (18-64), Older Adult (65+)
• Sampling Method: Non-Probability Sample

Study Population

Parturients that undergo intrapartum cesarean delivery with an epidural already in situ.

You may qualify if:

• Women with neuraxial labor analgesia (CSE, DPE, or Epidural) who have an intrapartum cesarean delivery
• Singleton gestation

You may not qualify if:

• No local anesthetic given in epidural for cesarean delivery (in emergency situation)
• Inadvertent dural puncture

Sponsors & Collaborators

• Mayo Clinic: lead
• University of British Columbia: collaborator

Study Sites (2)

Mayo Clinic

Rochester, Minnesota, 55902, United States

Location

BC Women's Hospital

Vancouver, British Columbia, Canada

Location

Related Links

• Mayo Clinic Clinical Trials

MeSH Terms

Conditions

Agnosia

Interventions

Injections, Epidural; Methods

Condition Hierarchy (Ancestors)

Perceptual Disorders; Neurobehavioral Manifestations; Neurologic Manifestations; Nervous System Diseases; Signs and Symptoms; Pathological Conditions, Signs and Symptoms

Intervention Hierarchy (Ancestors)

Injections, Spinal; Injections; Drug Administration Routes; Drug Therapy; Therapeutics; Investigative Techniques

Study Officials

• Emily Sharpe, MD

  Mayo Clinic

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: observational
• Observational Model: COHORT
• Time Perspective: RETROSPECTIVE
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Principal Investigator

Study Record Dates

• First Submitted: August 22, 2022
• First Posted: August 24, 2022
• Study Start: February 1, 2017
• Primary Completion (Estimated): July 1, 2026
• Study Completion (Estimated): July 1, 2026
• Last Updated: August 17, 2025

Record last verified: 2025-08

Data Sharing

• IPD Sharing: Will not share

Locations

US (1); CA (1)