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

Juan Davila-Velazquez; Jeffrey Bernstein

doi:10.1007/978-3-319-43169-7_45

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

Juan Davila-Velazquez, Jeffrey Bernstein

Anesthesiology

Research output: Chapter in Book/Report/Conference proceeding › Chapter

Abstract

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 language	English (US)
Title of host publication	You're Wrong, I'm Right: Dueling Authors Reexamine Classic Teachings in Anesthesia
Publisher	Springer International Publishing
Pages	153-154
Number of pages	2
ISBN (Electronic)	9783319431697
ISBN (Print)	9783319431673
DOIs	https://doi.org/10.1007/978-3-319-43169-7_45
State	Published - Jan 1 2016

Keywords

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

ASJC Scopus subject areas

Medicine(all)

Access to Document

10.1007/978-3-319-43169-7_45

Cite this

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abstract = "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.",

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N2 - 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.

AB - 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.

KW - Combined spinal epidural (CSE)

KW - Emergency cesarean delivery

KW - Epidural anesthesia

KW - Obstetric anesthesia

KW - Post-dural puncture headache

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

Abstract

Keywords

ASJC Scopus subject areas

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