Anesthesia Discussion > Obstetric Anesthesia
Does any one practiced combined spinal epidural in normal labour analgesia?
amorrahk:
do u have any experience about combined spinal opioid (what is the volume and concentration) epidural (anethetic) in analgesia of normal labour? :)
yogenbhatt1:
We used to give spinal Bupivacain Heavy 0.5 % 0.2 ml and 30mcg Fentanyl followed by Epidural management. We used to give it for a fast action.
Later we gave up the method. Almost all patients were getting severe spinal headache. May be they lost a lot of CSF
with each contraction and leaked a lot.
amorrahk:
do u mean there is leake with the combined needle (needle through needle technique)? as the spinal needle gauge is 27? is the contraction predispose to csf leak throught the very small tear??
yogenbhatt1:
We have always used saperate needle and space( Economy). It is always a 26 G needle. But it was our observation that all patients had PDPH. So much that the obstn. used to object to the method. I agree with you, that leak may not be there.
Regards
kalpesh shah:
Hi, sir i regularly use CSE for labour analgesia.
Incidence of PDPH is not realy vary high.
Infact the perineal analgesia largely unsatisfactory in only epidural technique.
Lots of international publication supports this perticular technique.
REGARDS.
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