Subsequent Epidural Analgesia Research Articles

MULTIDISCIPLINARY PAIN ABSTRACTS: 4 . Anesthesia (4)

In this study the authors investigated the duration of labor analgesia produced by a small dose of spinal bupivacaine/fentanyl alone or in combination with a small dose of morphine. Sixty parturients were enrolled in this placebo‐controlled, double‐blinded, randomized trial. All women received a spinal injection of 12.5 μg of fentanyl with 2 mg of bupivacaine. The morphine group (MBF) also received 125 μg of morphine; the placebo group (BF) received saline. Pain scores were <3 of 10 within 10 minutes of the injection. The median duration of analgesia was similar between groups (89 minutes versus 84 minutes), and only 20% of the MBF group experienced prolonged analgesia. During subsequent epidural analgesia, the MBF group had a significantly lesser rate of breakthrough pain (0.15 ± 0.14 episodes per hour versus 0.26 ± 0.18 episodes per hour). Also, during the first 24 hours postpartum, the MBF group required significantly fewer medications (3.3 ± 3.7 doses versus 4.7 ± 3.5 doses). Intrathecal injection of this small dose of bupivacaine/fentanyl produced a rapid onset of labor analgesia; the addition of a small dose of morphine did not significantly prolong analgesia, but it improved subsequent pain relief, as measured by the rate of breakthrough pain and postpartum medication requirements. This may provide a clinically useful means of improving intrapartum and postpartum pain relief. A small dose of intrathecal fentanyl 12.5 μg and bupivacaine 2 mg produces effective labor analgesia lasting for approximately 85 minutes. The addition of a small 125‐ μg dose of morphine improves pain control during subsequent epidural analgesia and reduces the requirements for postpartum pain medications.

Experience with the Use of Nitroprusside and Subsequent Epidural Analgesia in a Pregnant Quadriplegic Patient

Experience with the Use of Nitroprusside and Subsequent Epidural Analgesia in a Pregnant Quadriplegic Patient

Experience with the Use of Nitroprusside and Subsequent Epidural Analgesia in a Pregnant Quadriplegic Patient

Experience with the Use of Nitroprusside and Subsequent Epidural Analgesia in a Pregnant Quadriplegic Patient