Combined spinal-epidural versus epidural analgesia in labour

A comparison of paracervical block with single-shot spinal for labour analgesia in multiparous women: a randomised controlled trial

“…24 According to the recent meta-analysis of Simmons et al there are no differences in obstetric outcome between epidural and combined spinal-epidural analgesia. 25 In this study the progress of labour was similar in the two groups. The rate of instrumental delivery was low and not affected by possible analgesia-induced fetal distress.…”

Effect of combined spinal–epidural analgesia versus epidural analgesia on labor and delivery duration

“…A systematic review [8] did not make conclusions about the total duration of labor with CSEA versus LEA because usually this outcome is not the primary one and is under-reported. Nevertheless, most of the available data do not show differences in labor duration [9][10][11][12][13].…”

Analgesia and anesthesia

“…Both CSE and epidural techniques provide effective pain relief in labor. The type (opioids with or without local anesthetics) and concentration of local anesthetic used in the CSE or epidural technique impact maternal mobilization and other outcomes more than the technique itself (31). There appears to be little basis for offering CSE over epidurals in labor, with no difference in overall maternal satisfaction despite a slightly faster onset (about 6 minutes) with CSE, and less pruritus with epidurals.…”