RESUMO
We carried out an observational study to assess maternal satisfaction with st and ard epidural and combined spinal epidural [CSE]. We selected 60 nulliparous fullterm parturients who were in active labour and requested analgesia. They were divided into 3 groups For [group 1] st and ard epidural analgesia [10 ml of 0.25%] bupivacaine was injected into the epidural space followed by top-up of 10 ml of 0.125% bupivacaine as required. [Group 2], combined spinal-epidural fentanyl [CSEF] the initial dose was 25 micro g fentanyl in 2 ml normal saline followed by top - up of 25 micro g fentanyl in 5 ml in epidural catheter as required. [Group 3] combined spinal-epidural bupivacaine and fentanyl [mixed CSE], the initial intrathecal dose was 2.5 mg bupivacaine and fentanyl 25 micro g in 2ml normal saline, followed by top-up of 20 micro g fentanyl with 0.125% bupivacaine in 10 ml in epidural space as required. We found that the overall satisfaction was geater in the combined spinal-epidural groups than the st and ard epidural group. Good analgesia was achieved in all groups, but the combined spinal-epidural bupivacaine and fentanyl had faster onset and prolonged duration followed by combined spinal-epidural fentanyl and then st and ard epidural group, The leg weakness was more in st and ard epidural group and very mild in group 3 but absent in group 2. Overall, women seem to be satisfied with low dose combined spinal-epidural fentanyl and bupivacaine perhaps because of the faster onset, less motor blockade and feelings of greater self control