Combined spinal epidural anaesthesia: a new technique

A new technique is described for delivering combined spinal epidural anaesthesia. The disadvantages of the needle-through-needle technique and the two-needle techniques are discussed. The new technique is a modification of the two-needle technique. The spinal needle is introduced and once cerebrospinal fluid is seen at the hub of the needle, the stylet is replaced. The epidural space is then identified and the epidural catheter placed. The spinal needle obturator is then removed and intrathecal injection performed, This technique avoids problems associated with placing an epidural catheter after an intrathecal injection and the potential problem of placing a spinal needle when an epidural catheter has already been placed. This technique requires further evaluation.