Abstract
The modern application of the combined spinal-epidural (CSE) technique to obstetric care represents the culmination of nearly 100 years in the evolution of regional anesthetic techniques for obstetrics. CSE combines the advantages of rapid, consistent spinal blockade with the flexibility of drug administration via an epidural catheter. These advantages have been best realized in the setting of labor analgesia where the CSE technique has been most recently employed to achieve ambulatory labor analgesia. In this setting, the rapid onset of profound analgesia and the absence of motor blockade characteristic of CSE have been associated with high degrees of maternal satisfaction and increasing popularity among practitioners. In the setting of cesarean delivery, the CSE technique has provided practitioners with added flexibility for the safe management of the high-risk parturient.
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