Initiation of neuraxial labour analgesia

Labour can be a very painful process for which many parturients request analgesia. When neuraxial analgesia is chosen to manage labour pain, various choices have to be made, for example, which local anaesthetic drug, which maintenance strategy, and which adjuvant drug. The first choice, however, is how analgesia will be initiated. In this chapter the various options for analgesia (conventional epidural, combined spinal–epidural (CSE), caudal, and continuous spinal) are discussed. This chapter focuses more specifically on the choice between combined spinal–epidural and conventional epidural.