title: Combined spinal-epidural versus epidural analgesia for labor and delivery.
abstract: The rapid onset of analgesia and improved mobility with combined spinal-epidural (CSE) techniques has been associated with a higher degree of maternal satisfaction compared with conventional epidural analgesia. However, controversy exists in that initiation of labor analgesia with a CSE may be associated with an increased risk for nonreassuring fetal status (ie, fetal bradycardia) and a subsequent need for emergent cesarean delivery. Overall, both epidural and CSE techniques possess unique risk/benefit profiles, and the decision to use one technique rather than the other should be determined based on individual patient and clinical circumstances.
authors: Department of Anesthesiology, Mayo Clinic, 200 First Street Southwest, Rochester, MN 55905, USA.
authors: Adam D
authors: AD
authors: Niesen
authors: Adam K
authors: AK
authors: Jacob
mesh_terms: D015360:Analgesia, Epidural / Q000379:methods*; D016362:Analgesia, Obstetrical / Q000379:methods*; D000701:Analgesics, Opioid / Q000627:therapeutic use*; D000775:Anesthesia, Spinal / Q000379:methods*; D000779:Anesthetics, Local / Q000627:therapeutic use*; D002408:Catheters, Indwelling; D003131:Combined Modality Therapy; D005260:Female; D006340:Heart Rate, Fetal; D006801:Humans; D007022:Hypotension / Q000139:chemically induced; D048949:Labor Pain / Q000188:drug therapy*; D011247:Pregnancy; D011537:Pruritus / Q000139:chemically induced
chemical_list: D000701:Analgesics, Opioid; D000779:Anesthetics, Local
keywords: Combined spinal-epidural; Epidural; Labor analgesia