Which is safer: A traditional epidural or a combined spinal epidural?

Juan Davila-Velazquez, Jeffrey Bernstein

Research output: Chapter in Book/Report/Conference proceedingChapter


A 32-year-old primigravida at 5-cm dilatation, with regular contractions and intact membranes, is admitted to the labor floor in active labor. She is obese (body mass index [BMI] 41) and has a Mallampati class III airway. The rest of her medical history is unremarkable. After addressing her questions and concerns and signing consent, you perform a traditional epidural with loss of resistance to air, 6 cm from the skin. Aspiration and test dose are negative. The epidural catheter is loaded with 10 ml bupivacaine, 0.125 %, and fentanyl, 50 µ(mu)g. Patient-controlled epidural analgesia with both continuous and demand dosing is initiated before you leave the room.

Original languageEnglish (US)
Title of host publicationYou're Wrong, I'm Right: Dueling Authors Reexamine Classic Teachings in Anesthesia
PublisherSpringer International Publishing
Number of pages2
ISBN (Electronic)9783319431697
ISBN (Print)9783319431673
StatePublished - Jan 1 2016


  • Combined spinal epidural (CSE)
  • Emergency cesarean delivery
  • Epidural anesthesia
  • Obstetric anesthesia
  • Post-dural puncture headache

ASJC Scopus subject areas

  • Medicine(all)


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