| Autor: |
Tarshis, Jordan, Zuckerman, James E., Katz, Nathaniel P., Segal, Scott, Mushlin, Phillip S. |
| Zdroj: |
Canadian Journal of Anesthesia; December 1997, Vol. 44 Issue: 12 p1278-1281, 4p |
| Abstrakt: |
Purpose: We report the peripartum anaesthetic management for vaginal delivery of a chronic pain patient with an implanted intrathecal pump. This is the first report describing labour analgesia in a patient with such a device. As intrathecal systems become more popular for the management of nonmalignant pain, this situation is likely to be encountered with increasing frequency in the future. Clinical features: The patient was a nulliparous 23-yr-old with a history of chronic hereditary pancreatitis whose intractable pain had been managed with intrathecal morphine 3 mg·day−1via an implantable pump for four years. Inadequate time between presentation and onset of labour prevented us from using this system. Intravenous patient controlled analgesia with fentanyl using a bolus of 25 μg and a lockout of five minutes was ineffective and epidural analgesia using buprvacaine was initiated and resulted in satisfactory analgesia. Conclusion: The presence of an existing intrathecal delivery system does not preclude the use of supplemental epidural analgesia during labour. |
| Databáze: |
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