Abstract
Combined spinal epidural anesthesia (CSEA) offers the advantages of both spinal and epidural anesthesia: rapid onset and deep level of anesthesia, flexibility and postoperative analgesia. The disadvantage relating to single segment technique is the high incidence of failure, the risk of catheter migration, and drug transfer from the epidural space to the cerebrospinal fluid. The principal concern regarding the double segment technique is that the patient suffers twice as much pain. The mechanism of extended spinal anesthesia by epidural injection is largely the epidural volume effect. I hope CSEA is established as a more reliable method of regional anesthesia.
