Welcome to pain relief options during childbirth

What is combined spinal epidural techniques (CSE)?

Bhavani Shankar Kodali MD

Combined spinal epidural techniques (CSE) can combine the advantages of each technique.

Distinct advantages of CSE over the epidural are:
Rapid onset
Profound suppression of pain
Minimal loss of ability to move legs
Negligible amount of medications going to other systems of the body, including the baby
High satisfaction rate from the expectant mother

Procedure of Combined Spinal Epidural Anesthesia (CSE) 

In CSE, the epidural space is located as described under 'epidural anesthesia'. After locating the epidural space, a thin needle is passed through the epidural needle into the spinal fluid to inject a small amount of medication into the spinal fluid (spinal anesthesia). This results in the instantaneous onset of pain relief of child birth and you beginning to feel comfortable. The thin spinal needle is removed and an epidural catheter in inserted into the epidural space followed by the removal of the epidural needle. The epidural catheter is secured over the back in the usual fashion. An epidural pump gradually injects medications into the epidural space as described in 'epidural anesthesia'.The spinal part of the CSE usually lasts about 90 minutes. As the effect of spinal anesthesia wears off, epidural anesthesia kicks in and you will have comfortable pain relief. The epidural medications are adjusted to provide optimum pain relief until you deliver your baby.

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