Key result
Dural puncture epidural anesthesia using a 25-gauge needle significantly reduced the median onset time to surgical anesthesia compared to a 27-gauge needle (9.12 vs 14.18 minutes, HR 2.3).
Why the study?
Does DPEA using 25-gauge spinal needles improve the onset time to surgical anesthesia compared to 27-gauge needles in parturients undergoing elective cesarean section?
Population
110 ASA I and II parturients aged 20–35 years undergoing scheduled cesarean section
Comparison
25G vs 27G Whitacre pencil-point spinal needles during DPEA
Design
Randomized comparative study
Authors
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25G DPEA shortens onset to surgical anesthesia in elective cesarean delivery; extends RCT evidence on needle gauge selection for neuraxial block quality.
RCT (n=110)
Double-blind
1:1 ratio, blocks of 10
No
Does DPEA using 25-gauge spinal needles improve the onset time to surgical anesthesia compared to 27-gauge needles in parturients undergoing elective cesarean section?
Hazard Ratio: 2.3 (95% CI 1.79–3.14)
Absolute Event Rate: 9.12% vs 14.18%
p-value: p=<0.0001
DPEA using a 25-gauge spinal needle results in a significantly faster onset of surgical anesthesia and improved block quality compared to a 27-gauge needle during elective cesarean section.
Abdelrahman et al. (2025) conducted an RCT in Elective cesarean section (n=110). 25-gauge pencil-point spinal needle (25G-DPEA) vs. 27-gauge pencil-point spinal needle (27G-DPEA) was evaluated on Time taken from the start of epidural extension until achievement of bilateral T6 sensory block (onset time to surgical anesthesia) (HR 2.3, 95% CI 1.79-3.14, p=<0.0001). Dural puncture epidural anesthesia using a 25-gauge needle significantly reduced the median onset time to surgical anesthesia compared to a 27-gauge needle (9.12 vs 14.18 minutes, HR 2.3).
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