Table 1.

Protocol of CSEA administration in primiparous woman

Cervical dilatation	Station of fetal head	Initial dose		Subsequent dose
Centimeters	Level	Medication, and intrathecal dose	Intrathecal volume (ml)	Medication, and epidural dose	Epidural volume (ml)
2–3	− 2/− 1	Sufentanil 2.5 mg	5	Ropivacaine 0.05–0.10% or levobupivacaine 0.05–0.0625%	15–20
3–5	− 1	Ropivacaine 0.04% or levobupivacaine 0.025% and sufentanil 2.5 mg	5	Ropivacaine 0.05–0.10% or levobupivacaine 0.0625%	15–20
> 6	− 1	Ropivacaine 0.05–0.06% or levobupivacaine 0.03–0.04% and sufentanil 2.5 mg	5	Ropivacaine 0.10% or levobupivacaine 0.0625%	20
Full cervical dilatation	− 1/0	Ropivacaine 0.06% or levobupivacaine 0.05%	5	Ropivacaine 0.15% or levobupivacaine 0.0625%	15

At full cervical dilation, after the complete rotation of the fetal head, it can be administered 5–7 ml of mepivacaine or lidocaine 1% for perineal analgesia or for an episiotomy/episiorrhaphy