Anaes SAQs · Neuraxial anaesthesia
Combined spinal-epidural — technique and place
Final-viva question on the CSE: the needle-through-needle technique, the single- versus double-space approaches, the dural-puncture-epidural variant, the advantages (rapid onset plus titration) and indications (labour, caesarean, prolonged surgery), and the complications (PDPH, catheter migration, failed block, hypotension).
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Prompt
Describe the combined spinal-epidural technique, its advantages and indications over a plain spinal or epidural, and its complications.
Question
Describe the combined spinal-epidural technique, its advantages and indications over a plain spinal or epidural, and its complications[1][4].
References4ShowHide
- [1]Roofthooft E, Rawal N, Van de Velde M Current status of the combined spinal-epidural technique in obstetrics and surgery. Best Pract Res Clin Anaesthesiol, 2023.PMID 37321766
- [2]Chino K, Rollins MD, Warrick C, et al. Post-dural Puncture Headache in Dural Puncture Epidural and Combined Spinal-Epidural Using 24- and 25-Gauge Needles Versus Conventional Epidural Labor Analgesia: A Systematic Review and Meta-analysis. Anesth Analg, 2026.PMID 42155003
- [3]Vallejo MC, Lilly CL, Saracoglu A, et al. Factors Associated With Unintended Dural Puncture and Failed Neuraxial Anesthesia in Obstetric Anesthesia. Cureus, 2026.PMID 42199590
- [4]Basheer P, Brijesh GC, Kumar R, et al. A Clinical Comparison between Single-Space Technique and Double-Space Technique for Combined Spinal and Epidural Anesthesia. Anesth Essays Res, 2022.PMID 36249131