The use of a combined spinal-epidural, or walking epidural, has gained popularity in recent years. This technique involves passing a very small pencil-point needle through the epidural needle prior to placement of the epidural anesthetic. The smaller needle is advanced into the space adjacent to the spinal cord (the subarachnoid or subdural space). Using a smaller needle to place the spinal anesthetic helps to prevent the complication of a spinal headache. It is less likely that spinal fluid will leak when a smaller needle is placed into the spinal space.
A very small dose of either a narcotic or local anesthetic is then injected into the space. This allows only the sensory function to be affected, which enables the patient to walk and move during labor. Side effects are usually mild, and may include itching and nausea. This technique is sometimes used during the latent phase of the first stage of labor. The pain relief may not be sufficient during the active phases of the first and second stages of labor.
For more information, go to Risks of Epidurals During Delivery and Do Epidurals Affect Labor?
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