Comparative Study of Labour Analgesia Onset With Injection of Loading Dose Through Epidural Needle Versus Catheter: A Prospective, Double-blinded, Randomized Clinical Trial

( Eur J Anaesthesiol . 2025;42(2):113-121. doi: 10.1097/EJA.0000000000002077) Epidural (EPI) and combined spinal-epidural (CSE) analgesia are common methods of pain relief during labor. The combined method has a faster onset for pain relief and is also associated with increased risk for maternal hypotension and fetal bradycardia. It is possible to inject the initial drug dose with the epidural needle rather than the epidural catheter, which could achieve a greater degree of drug spread and a faster onset, though studies assessing this effect are lacking. This study was designed to evaluate a high-volume loading dose of ropivacaine combined with sufentanil injected into the epidural space through the Tuohy epidural needle rather than the epidural catheter. Authors hypothesized that needle injection would reduce the time to onset of analgesia and reduce drug consumption with improved quality of analgesia.