Lancet
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Randomized Controlled Trial Comparative Study Clinical Trial
Randomised comparison of combined spinal-epidural and standard epidural analgesia in labour.
Epidural analgesia has a well-established role in labour, but has the drawbacks of delayed onset and motor blockade. The combined spinal-epidural technique may overcome these drawbacks. We carried out a randomised observational study to assess maternal satisfaction with the standard and combined techniques among 197 women in labour. ⋯ In the standard epidural group 32 had leg weakness at 20 min (p = 0.001), and the proportion of mothers with weakness increased in this group during labour. There were no differences in side-effects, except for mild pruritus, which was more common in the combined spinal-epidural group (42 vs 1%; p < 0.0001). Overall, women seem to prefer the low-dose combined spinal-epidural technique to standard epidurals, perhaps because of the faster onset, less motor block, and feelings of greater self-control.