{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,14]],"date-time":"2026-07-14T04:35:16Z","timestamp":1784003716230,"version":"3.55.0"},"reference-count":24,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2025,11,26]],"date-time":"2025-11-26T00:00:00Z","timestamp":1764115200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"},{"start":{"date-parts":[[2025,11,26]],"date-time":"2025-11-26T00:00:00Z","timestamp":1764115200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"}],"funder":[{"name":"Shaoxing Health Technology Program Project","award":["2023SKY050"],"award-info":[{"award-number":["2023SKY050"]}]},{"name":"Shaoxing Municipal Science and Technology Project","award":["2024A14011"],"award-info":[{"award-number":["2024A14011"]}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Anesthesiol"],"DOI":"10.1186\/s12871-025-03463-7","type":"journal-article","created":{"date-parts":[[2025,11,26]],"date-time":"2025-11-26T15:30:37Z","timestamp":1764171037000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Dural puncture epidural technique with 23-, 25- or 27-gauge pencil point spinal needles versus standard epidural technique for labor analgesia: a randomized trial"],"prefix":"10.1186","volume":"25","author":[{"given":"Zheng-bin","family":"Pan","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jie-feng","family":"Chen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jie-lan","family":"Ding","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhi-min","family":"Sheng","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hao","family":"Lv","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhong","family":"Mei","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wei-wei","family":"Shui","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yiyu","family":"Pan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,11,26]]},"reference":[{"key":"3463_CR1","doi-asserted-by":"publisher","unstructured":"Coviello A, Iacovazzo C, Frigo MG et al. Technical aspects of neuraxial analgesia during labor and maternity care: an updated overview. J Anesth Analg Crit Care. 2025;5(1):6. Published 2025 Jan 29. https:\/\/doi.org\/10.1186\/s44158-025-00224-3","DOI":"10.1186\/s44158-025-00224-3"},{"key":"3463_CR2","doi-asserted-by":"publisher","first-page":"5","DOI":"10.1016\/j.jclinane.2018.09.030","volume":"53","author":"S Layera","year":"2019","unstructured":"Layera S, Bravo D, Aliste J, Tran DQ. A systematic review of DURAL puncture epidural analgesia for labor. J Clin Anesth. 2019;53:5\u201310. https:\/\/doi.org\/10.1016\/j.jclinane.2018.09.030.","journal-title":"J Clin Anesth"},{"key":"3463_CR3","doi-asserted-by":"publisher","DOI":"10.1136\/rapm-2019-100608","author":"F Contreras","year":"2019","unstructured":"Contreras F, Morales J, Bravo D, et al. Dural puncture epidural analgesia for labor: a randomized comparison between 25-gauge and 27-gauge pencil point spinal needles. Reg Anesth Pain Med. 2019. https:\/\/doi.org\/10.1136\/rapm-2019-100608.","journal-title":"Reg Anesth Pain Med"},{"key":"3463_CR4","doi-asserted-by":"publisher","first-page":"104217","DOI":"10.1016\/j.ijoa.2024.104217","volume":"60","author":"L Frassanito","year":"2024","unstructured":"Frassanito L, Filetici N, Piersanti A, et al. Sacral sensory Blockade from 27-gauge pencil-point dural puncture epidural analgesia or epidural analgesia in laboring nulliparous parturients: a randomized controlled trial. Int J Obstet Anesth. 2024;60:104217. https:\/\/doi.org\/10.1016\/j.ijoa.2024.104217.","journal-title":"Int J Obstet Anesth"},{"key":"3463_CR5","doi-asserted-by":"publisher","DOI":"10.1136\/rapm-2024-105468","author":"HQ Yao","year":"2024","unstructured":"Yao HQ, Qian J, Dong FY, et al. Comparison of the dural puncture epidural and the standard epidural techniques in patients having labor analgesia maintained using programmed epidural boluses: a prospective double-blinded randomized clinical trial. Reg Anesth Pain Med. 2024. https:\/\/doi.org\/10.1136\/rapm-2024-105468.","journal-title":"Reg Anesth Pain Med"},{"issue":"2","key":"3463_CR6","doi-asserted-by":"publisher","first-page":"560","DOI":"10.1213\/ANE.0000000000001798","volume":"124","author":"A Chau","year":"2017","unstructured":"Chau A, Bibbo C, Huang CC, et al. Dural puncture epidural technique improves labor analgesia quality with fewer side effects compared with epidural and combined spinal epidural techniques: A randomized clinical trial. Anesth Analg. 2017;124(2):560\u20139. https:\/\/doi.org\/10.1213\/ANE.0000000000001798.","journal-title":"Anesth Analg"},{"issue":"4","key":"3463_CR7","doi-asserted-by":"publisher","first-page":"971","DOI":"10.1213\/ANE.0000000000004768","volume":"132","author":"Y Song","year":"2021","unstructured":"Song Y, Du W, Zhou S, et al. Effect of dural puncture epidural technique combined with programmed intermittent epidural bolus on labor analgesia onset and maintenance: A randomized controlled trial. Anesth Analg. 2021;132(4):971\u20138. https:\/\/doi.org\/10.1213\/ANE.0000000000004768.","journal-title":"Anesth Analg"},{"issue":"2","key":"3463_CR8","doi-asserted-by":"publisher","first-page":"545","DOI":"10.1213\/ANE.0000000000002129","volume":"126","author":"SH Wilson","year":"2018","unstructured":"Wilson SH, Wolf BJ, Bingham K, et al. Labor analgesia onset with dural puncture epidural versus traditional epidural using a 26-Gauge Whitacre needle and 0.125% bupivacaine bolus: A randomized clinical trial. Anesth Analg. 2018;126(2):545\u201351. https:\/\/doi.org\/10.1213\/ANE.0000000000002129.","journal-title":"Anesth Analg"},{"issue":"8","key":"3463_CR9","doi-asserted-by":"publisher","first-page":"1098","DOI":"10.1111\/anae.15320","volume":"76","author":"B Maranhao","year":"2021","unstructured":"Maranhao B, Liu M, Palanisamy A, Monks DT, Singh PM. The association between post-dural puncture headache and needle type during spinal anaesthesia: a systematic review and network meta-analysis. Anaesthesia. 2021;76(8):1098\u2013110. https:\/\/doi.org\/10.1111\/anae.15320.","journal-title":"Anaesthesia"},{"key":"3463_CR10","doi-asserted-by":"publisher","unstructured":"Pa\u017eur I, O\u017eegi\u0107 O, Lijovi\u0107 L, Jai\u0107 KK, Pe\u0161i\u0107 M. The efficacy of dural puncture epidural performed by 27-gauge Whitacre needle in labour epidural analgesia: randomized Single-Blinded controlled study. Turk J Anaesthesiol Reanim. 2023;51(4):304\u201310. https:\/\/doi.org\/10.4274\/TJAR.2023.221085.","DOI":"10.4274\/TJAR.2023.221085"},{"issue":"5","key":"3463_CR11","doi-asserted-by":"publisher","first-page":"1046","DOI":"10.1097\/00000542-200511000-00019","volume":"103","author":"JA Thomas","year":"2005","unstructured":"Thomas JA, Pan PH, Harris LC, Owen MD, D\u2019Angelo R. Dural puncture with a 27-gauge Whitacre needle as part of a combined spinal-epidural technique does not improve labor epidural catheter function. Anesthesiology. 2005;103(5):1046\u201351. https:\/\/doi.org\/10.1097\/00000542-200511000-00019.","journal-title":"Anesthesiology"},{"issue":"3","key":"3463_CR12","doi-asserted-by":"publisher","first-page":"810","DOI":"10.1213\/01.ane.0000101987.79454.bc","volume":"98","author":"E Lew","year":"2004","unstructured":"Lew E, Yeo SW, Thomas E. Combined spinal-epidural anesthesia using epidural volume extension leads to faster motor recovery after elective Cesarean delivery: a prospective, randomized, double-blind study. Anesth Analg. 2004;98(3):810\u20134. https:\/\/doi.org\/10.1213\/01.ane.0000101987.79454.bc. table of contents.","journal-title":"Anesth Analg"},{"issue":"5","key":"3463_CR13","doi-asserted-by":"publisher","first-page":"1097","DOI":"10.1097\/00000539-199711000-00024","volume":"85","author":"T Takiguchi","year":"1997","unstructured":"Takiguchi T, Okano T, Egawa H, Okubo Y, Saito K, Kitajima T. The effect of epidural saline injection on analgesic level during combined spinal and epidural anesthesia assessed clinically and myelographically. Anesth Analg. 1997;85(5):1097\u2013100. https:\/\/doi.org\/10.1097\/00000539-199711000-00024.","journal-title":"Anesth Analg"},{"issue":"5","key":"3463_CR14","doi-asserted-by":"publisher","first-page":"526","DOI":"10.1111\/vaa.12147","volume":"41","author":"WG Son","year":"2014","unstructured":"Son WG, Jang M, Yoon J, Lee LY, Lee I. The effect of epidural injection speed on epidural pressure and distribution of solution in anesthetized dogs. Vet Anaesth Analg. 2014;41(5):526\u201333. https:\/\/doi.org\/10.1111\/vaa.12147.","journal-title":"Vet Anaesth Analg"},{"key":"3463_CR15","doi-asserted-by":"publisher","first-page":"3797","DOI":"10.2147\/JPR.S424082","volume":"16","author":"W Lin","year":"2023","unstructured":"Lin W, Yang Y, Lin J, Chen J, Lin Q. Dural puncture epidural with 25-G spinal needles versus conventional epidural technique in conjunction with PIEB for labor analgesia: A randomized trial. J Pain Res. 2023;16:3797\u2013805. https:\/\/doi.org\/10.2147\/JPR.S424082.","journal-title":"J Pain Res"},{"issue":"4","key":"3463_CR16","doi-asserted-by":"publisher","first-page":"745","DOI":"10.1097\/ALN.0000000000002089","volume":"128","author":"EMS Lange","year":"2018","unstructured":"Lange EMS, Wong CA, Fitzgerald PC, et al. Effect of epidural infusion bolus delivery rate on the duration of labor analgesia: A randomized clinical trial. Anesthesiology. 2018;128(4):745\u201353. https:\/\/doi.org\/10.1097\/ALN.0000000000002089.","journal-title":"Anesthesiology"},{"issue":"1","key":"3463_CR17","doi-asserted-by":"publisher","first-page":"86","DOI":"10.1007\/s12630-021-02132-w","volume":"69","author":"Y Mazda","year":"2022","unstructured":"Mazda Y, Arzola C, Downey K, Ye XY, Carvalho JCA. Programmed intermittent epidural bolus for labour analgesia: a randomized controlled trial comparing bolus delivery speeds of 125 mL\u00b7hr-1 versus 250 mL\u00b7hr-1. Can J Anaesth. 2022;69(1):86\u201396. https:\/\/doi.org\/10.1007\/s12630-021-02132-w.","journal-title":"Can J Anaesth"},{"issue":"6","key":"3463_CR18","doi-asserted-by":"publisher","first-page":"709","DOI":"10.1097\/AAP.0000000000000667","volume":"42","author":"MA Reina","year":"2017","unstructured":"Reina MA, Puigdell\u00edvol-S\u00e1nchez A, Gatt SP, De Andr\u00e9s J, Prats-Galino A, van Zundert A. Electron microscopy of dural and arachnoid disruptions after subarachnoid block. Reg Anesth Pain Med. 2017;42(6):709\u201318. https:\/\/doi.org\/10.1097\/AAP.0000000000000667.","journal-title":"Reg Anesth Pain Med"},{"issue":"10126","key":"3463_CR19","doi-asserted-by":"publisher","first-page":"1197","DOI":"10.1016\/S0140-6736(17)32451-0","volume":"391","author":"S Nath","year":"2018","unstructured":"Nath S, Koziarz A, Badhiwala JH, et al. Atraumatic versus conventional lumbar puncture needles: a systematic review and meta-analysis. Lancet. 2018;391(10126):1197\u2013204. https:\/\/doi.org\/10.1016\/S0140-6736(17)32451-0.","journal-title":"Lancet"},{"issue":"3","key":"3463_CR20","doi-asserted-by":"publisher","first-page":"168","DOI":"10.1054\/ijoa.2000.0834","volume":"10","author":"R Landau","year":"2001","unstructured":"Landau R, Ciliberto CF, Goodman SR, Kim-Lo SH, Smiley RM. Complications with 25-gauge and 27-gauge Whitacre needles during combined spinal-epidural analgesia in labor. Int J Obstet Anesth. 2001;10(3):168\u201371. https:\/\/doi.org\/10.1054\/ijoa.2000.0834.","journal-title":"Int J Obstet Anesth"},{"key":"3463_CR21","doi-asserted-by":"crossref","unstructured":"Celleno D, Capogna G, Costantino P, Catalano P. An anatomic study of the effects of dural puncture with different spinal needles. Reg Anesth. 1993;18(4):218\u201321.","DOI":"10.1136\/rapm-00115550-199318040-00004"},{"issue":"1","key":"3463_CR22","doi-asserted-by":"publisher","first-page":"201","DOI":"10.1213\/ANE.0000000000006792","volume":"139","author":"YS Ranganath","year":"2024","unstructured":"Ranganath YS, Ramanujam V, Al-Hassan Q, et al. Loss-of-Resistance versus dynamic Pressure-Sensing technology for successful placement of thoracic epidural catheters: A randomized clinical trial. Anesth Analg. 2024;139(1):201\u201310. https:\/\/doi.org\/10.1213\/ANE.0000000000006792.","journal-title":"Anesth Analg"},{"issue":"5","key":"3463_CR23","doi-asserted-by":"publisher","first-page":"678","DOI":"10.1097\/ALN.0000000000004137","volume":"136","author":"HS Tan","year":"2022","unstructured":"Tan HS, Reed SE, Mehdiratta JE, et al. Quality of labor analgesia with dural puncture epidural versus standard epidural technique in obese parturients: A Double-blind randomized controlled study. Anesthesiology. 2022;136(5):678\u201387. https:\/\/doi.org\/10.1097\/ALN.0000000000004137.","journal-title":"Anesthesiology"},{"issue":"6","key":"3463_CR24","doi-asserted-by":"publisher","first-page":"739","DOI":"10.1093\/bja\/aep096","volume":"102","author":"PD Fettes","year":"2009","unstructured":"Fettes PD, Jansson JR, Wildsmith JA. Failed spinal anaesthesia: mechanisms, management, and prevention. Br J Anaesth. 2009;102(6):739\u201348. https:\/\/doi.org\/10.1093\/bja\/aep096.","journal-title":"Br J Anaesth"}],"container-title":["BMC Anesthesiology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12871-025-03463-7.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s12871-025-03463-7\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12871-025-03463-7.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,11,26]],"date-time":"2025-11-26T15:30:38Z","timestamp":1764171038000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmcanesthesiol.biomedcentral.com\/articles\/10.1186\/s12871-025-03463-7"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,11,26]]},"references-count":24,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2025,12]]}},"alternative-id":["3463"],"URL":"https:\/\/doi.org\/10.1186\/s12871-025-03463-7","relation":{},"ISSN":["1471-2253"],"issn-type":[{"value":"1471-2253","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,11,26]]},"assertion":[{"value":"8 May 2025","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"24 October 2025","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"26 November 2025","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"This study was approved by the Ethics Committee of Shaoxing Maternity and Child Health Care Hospital (Shaoxing, Zhejiang Province, China) (Approval No. IRB-AF-022-01.2), registered at the Chinese Clinical Trial Registry (\n                      \n                      , registration No. ChiCTR2400082374, principal investigator: Jie-feng Chen) on March 27, 2024. It adheres to the principles outlined in the Declaration of Helsinki and the CONSORT 2010 guidelines. Informed written consents were obtained from all subjects. We confirm our study complies with the Declaration of Helsinki.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"591"}}