Combined spinal epidural anaesthesia: the single space double-barrel technique

We present our own single-space method for performing combined spinal epidural anaesthesia. A spinal introducer and a Tuohy needle are sited in the same interspace. After insertion of the epidural catheter the introducer is used as a guide for a 25 gauge spinal needle. The advantages of this technique over other methods are explored. A series of 90 patients who received combined spinal epidural anaesthesia for elective Caesarean section is presented. The incidence of side effects (hypotension, nausea and vomiting, itching, post dural puncture headache) was comparable with those of other series. However, a high incidence (26.6%) of paraesthesiae during insertion of the spinal needle was noted. We suggest that this finding may be related to the use of pencil-point needles.