Tendencias y avances actuales en anestesia obstétrica: La técnica combinada espinal-epidural para analgesia ambulatoria en trabajo de parto

the combined spinal-epidural labor analgesia technique (csea) has attained wide spread popularity in obstetric anesthesia worldwide. the onset of analgesia is rapid and reliable, and maternal satisfaction is high. while there still remains some concern about dural puncture, the csea technique offers many advantages to the parturient. continuous search for a balanced labor analgesia, which provides relief of pain of contractions while preserving motor function, has led to the development of the ambulatory labor analgesia. the csea performed with subarachnoid opioids (with or without local anesthetics) causes minimal motor block and is particularly applicable to ambulatory labor analgesia. the purpose of this paper is to review the available clinical data and provide recommendation for the application of the csea technique for ambulatory labor analgesia.