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The Value of Combined Spinal Epidural Sets

The popularity of the combined spinal-epidural technique (CSE) has grown tremendously over the last couple of decades. Defined by its use in the same procedure, CSE is an anesthetic choice where intentional injection of drug into the subarachnoid space is paired with the placement of a catheter into the epidural space. From obstetrics to non-obstetric surgery, the use of CSE sets has increased efficiency and accuracy dramatically when the technique is used properly.


One of the main benefits of CSE sets lies in the combination of both spinal anesthesia and epidural anesthesia. This anesthetic choice includes an initial subarachnoid injection followed by epidural catheter placement and subsequent administration of epidural medications. The dual advantage here is highlighted by the rapid onset of a predictable block (the spinal component) in addition to the long lasting analgesia and the ability to titrate the dose given to the desired effect (the indwelling epidural catheter).



Combined spinal epidural anesthesia has helped countless subsets of the medical industry and, most importantly, their patients:

  • Obstetrics

  • Postoperative Pain Management

  • General Surgery

  • Orthopedics (Hip and Knee Replacements)

  • Trauma Surgery

  • Urological Surgery

  • Gynecological Surgery

Clinical studies have shown that the CSE technique, when administered correctly, offers supreme surgical conditions, many of which emphasize advantages compared to a conventional epidural block.


Precision and Control with Combined Spinal Epidural Anesthesia

Combined spinal epidural anesthesia plays a critical role for anesthesiologists to not only provide better patient care, but to do so in a way that minimizes risk. Physicians across the globe have touted the superiority of CSE compared to epidural anesthesia. Some of the most important reasons for the preference for the CSE technique include:

  • Faster onset, typically saving 15-20 minutes

  • Much lower failure rate

  • A more intense motor block

In addition, it is important to mention the incident of post dural puncture headaches (PDPH). Some studies have shown a decrease in incidence compared to the epidural technique, while others have noted an increased incidence. While other factors certainly play a role in the probability for PDPH to occur, the type of needle and the length of needle used is paramount in reducing the likelihood of PDPH occurrence.


The Benefits of Gertie Marx Needles

The Gertie Marx atraumatic spinal needle is the only needle on the market that is engineered to be anatomically correct, resulting in superior clinical results. Under Gertie Marx’s supervision & guidance, these needle specifications were designed to have the Gertie Marx needle fit perfectly into the subarachnoid space. These are the spinal needle physicians should be using for best clinical results for both the physician and patient.


In addition to significantly reducing the incidence of PDPH, the Gertie Marx needle has had impressive results in terms of obtaining cerebrospinal fluid (CSF). While a research study comparing equipment found that the 24-gauge Sprotte needle failed to obtain CSF at a rate of 17%, the Gertie Marx needle had a 0% failure rate. The Sprotte needle is 9 mm in length beyond the top of the Tuohy needle with the hubs engaged; the Gertie Marx needle extends 17 mm beyond the tip of the Tuohy needle. The shorter needle is clearly inadequate for many patients, as the shorter needle is associated with higher failure rates.


Multiple studies have shown that longer needles are more effective at obtaining CSF for Combined Spinal Analgesia. IMD Corp offers a comprehensive range of individually packaged, sterile needles in a variety of longer lengths for Neuraxial Anesthesia (Spinal, Epidural and CSE).


IMD Corp’s CSE Sets are Ready to Ship Today

The CSE technique has proven to be an effective method for a variety of surgeries. The benefits speak for themselves:

  • Rapid relief of pain or induction of regional anesthesia by the rapid onset of the spinal drugs and subsequent administration of medications for prolonged anesthesia

  • Postoperative analgesia via the epidural catheter can be delivered for extended periods

  • Clinical studies have demonstrated that the CSE technique provides excellent surgical conditions as quickly as the single-shot subarachnoid block and with advantages in comparison to the conventional epidural block

IMD Corp develops, manufactures, and distributes innovative spinal needles to institutions worldwide. We offer a diverse range of needles with the most comprehensive range of sizes offered anywhere. Whether working in pediatrics or with morbidly obese patients, we offer the ideal size and gauge for each application and patient.


Our spinal needles are fully stocked and ready to ship immediately. To learn more about our CSE sets or to place an order, please visit our website.