The test dose can alter the initial effect of local anesthetic/narcotic mixture that is infused. In this study, a 3-mL 1.5% lidocaine-epinephrine test dose used with the more concentrated bupivacaine 0.125% did reduce the incidence of ambulation in patients at 30 minutes, although there was no difference later on.

There was no difference in overall satisfaction for analgesia, nor for walking among any of the treatment groups. Overall satisfaction was measured using a verbal scale of 0 to 10, where 0 = completely dissatisfied and 10 = extremely satisfied. Cohen states: "Satisfaction with analgesia was high in all groups (range of mean scores, 9-9.4) with no differences among the groups. Similarly, satisfaction scores for walking did not differ among the groups (range of mean scores, 6-7.5)." This isn't surprising because most laboring patients request epidurals for pain relief. However, even with the high incidence of ambulation in this study, the walking satisfaction score was somewhat reduced compared to the analgesic satisfaction score. Could it be that the term "walking epidural" conveys to parturients unrealistic expectations of how they will be able to function during their labor? Do they expect to have analgesia but totally normal motor function?

In this study the parturients were allowed to walk before applying various motor and sensory tests which are often used as predictors of safe ambulation. This sequence of walking and then testing may account for the higher ambulation rate in this study when compared with other studies. At the same time this sequence may indicate that certain of these predictors of safe ambulating are in fact too conservative, or at least not precise enough to define who may safely ambulate after a neuraxial block. And this is suggested by the fact that 37% of patients who could not perform deep knee bends (90°) after epidural establishment were able to walk safely.