[Combined spinal-epidural anaesthesia for pain relief in obstetric patients].

Besides epidural analgesia combined spinal-epidural anaesthesia (CSE) is one of the favourite techniques of regional anaesthesia for pain relief in obstetric patients. CSE combines the advantage of spinal anaesthesia, e.g. rapid onset and reliable effect, with the advantage of continuous epidural anaesthesia, e.g. titration of analgesics and prolongation. While subarachnoid injection of solely opioids provides fast pain relief for nearly 2 hrs in the first stage of labour with an opportunity of ambulation for the parturient ("walking epidural"), the subarachnoid injection of a combination of low doses of opoids and local anaesthetics provides profound analgesia with minor motor blocking side effects for 1-2 hrs in the second stage of labour.