A 28-year-old woman in active labour requests analgesia. She is at 4 cm cervical dilation. Which neuraxial technique provides the most effective analgesia while allowing her to ambulate?

• A Combined spinal-epidural (CSE) anaesthesia ✓
• B Single-shot spinal anaesthesia
• C Intramuscular morphine
• D Epidural with high concentration bupivacaine (0.5%)

Explanation

Combined spinal-epidural (CSE) provides rapid onset (spinal component) and prolonged duration (epidural component). Using low-dose local anaesthetics and opioids in the epidural component allows for effective analgesia while preserving motor function, enabling the patient to ambulate (walking epidural).

Reference: Chestnut's Obstetric Anesthesia, 6th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.