Combined Spinal Epidural and Dural Puncture Epidural

Abstract

The standard epidural (CEA) involves the placement of a catheter into the epidural space. There are two recently popularized variations on this standard technique: dural puncture epidural (DPE) and combined spinal-epidural (CSE). CEA: placement of a catheter into the epidural space CSE: puncturing the dura with a spinal needle and injection of medication into the intrathecal space followed by placement of a catheter into the epidural space. DPE: the dural is punctured but no medication is injected into the intrathecal space. After the puncture, an epidural catheter is placed.