Objective To compare the clinical efficacy of dural puncture epidural block (DPE) and epidural block (EP) combined with fully patient-controlled epidural bolus in labor analgesia. Methods A total of 120 primiparous women were enrolled and randomly divided into the EP group and DPE group. The maintenance analgesic mode for both groups was fully patient-controlled epidural bolus analgesia. The drug configuration ratio was 0.1% ropivacaine combined with sufentanil 0.5 μg/mL. The first dose of the pulsed analgesic pump was 10 mL, the self-controlled dose was 10 mL, the background dose was not set, and the locking time was 15 min. The primary outcome measure was the rate of adequate analgesia (pain visual analogue rating scale score≤30 mm) achieved 10 minutes (T1) after labor analgesia. The observation time points were set as 10 min before labor analgesia (T0), 10 min after analgesia (T1), 20 min after analgesia (T2), 30 min after analgesia (T3), and at the time of the cervix being fully dilated (T4). Secondary outcomes included analgesia block quality, patient-controlled epidural bolus analgesia (PCEA) pump use, adverse reactions, and delivery outcomes. Results The adequate analgesia rate of women in the DPE group at T1 and T3 was higher than that in the EP group (all P0.05), and the pain VAS scores at T1, T3, and T4 were lower than those in the EP group (all P0.05). The NRS scores of maternal satisfaction with the rate of reaching S2 at the block level, onset of response, and maintenance in the DPE group were higher than those in the EP group (all P0.05). Additionally, those in the DPE group were lower than those in the EP group (all P0.05) in terms of drug consumption dose, differences in the number of PCEA self-control times, and the duration of the second stage of labor. There were no significant differences in the incidence of adverse reactions, oxytocin use before and after analgesia, mode of delivery, two-hour postpartum blood loss, and neonatal Apgar score between the two groups (all P0.05). Conclusion Compared with EP, DPE has significant advantages in the onset rate of labor analgesia and sacral nerve block effect, which can improve the quality and satisfaction of labor analgesia, reduce the dosage of analgesics, and have no significant adverse effects.