Combined spinal epidural does not cause a higher sensory block than single shot spinal technique for cesarean delivery in laboring women.

Abstract

The combined spinal epidural (CSE) technique has been shown to result in a higher sensory block than an equivalent single shot spinal (SSS) in women undergoing elective cesarean delivery. We tested whether this is true also in laboring women who may have variable epidural pressures. We randomized 40 ASA I parturients in established labor for cesarean delivery into our double-blind study. Group S (n = 20) intrathecally received 2 mL of 0.5% hyperbaric bupivacaine by SSS and group CS received CSE (n = 20) of an equivalent dose of hyperbaric bupivacaine. We found that similar maximal sensory blocks were achieved in both groups (group S: median T3 [min-max] T6-1 versus group CS: median T3 [min-max] T4-C7, P = 0.517). As compared with previous reports in nonlaboring parturients, the block characteristics of CSE in our study were indistinguishable from those of SSS in laboring parturients for cesarean delivery.