Document Detail

Autonomic hyperreflexia during labour.
MedLine Citation:
PMID:  8595690     Owner:  NLM     Status:  MEDLINE    
We present two cases of automatic hyperreflexia (AH) during labour in women with spinal cord damage, in whom AH developed before and after delivery. The AH was successfully controlled using epidural anaesthesia in Case #1, but failed in Case #2. The blood pressure was controlled with nicardipine. However, overdose of nicardipine produces vasodilation and its side effects include headache, flushing and palpitation similar to AH. Considering these effects, we recommend epidural anaesthesia to control AH, because epidural anaesthesia does not only reduce BP, but also blocks the noxious stimuli and relieves the symptoms of AH. Our experience suggests that the epidural catheter can be placed two to three weeks before the date of predicted childbirth, because the onset of labour in a patient with spinal cord damage is difficult to predict and can proceed very rapidly. Also, the epidural catheter is available after the delivery. We recommended the epidural catheter is maintained for 24-48 hr postpartum.
A Kobayashi; T Mizobe; H Tojo; S Hashimoto
Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  Canadian journal of anaesthesia = Journal canadien d'anesthésie     Volume:  42     ISSN:  0832-610X     ISO Abbreviation:  Can J Anaesth     Publication Date:  1995 Dec 
Date Detail:
Created Date:  1996-04-12     Completed Date:  1996-04-12     Revised Date:  2005-11-17    
Medline Journal Info:
Nlm Unique ID:  8701709     Medline TA:  Can J Anaesth     Country:  CANADA    
Other Details:
Languages:  eng     Pagination:  1134-6     Citation Subset:  IM    
Department of Anesthesiology, Kyoto Prefectural University of Medicine, Japan.
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MeSH Terms
Anesthesia, Epidural
Anesthesia, Obstetrical
Autonomic Nervous System Diseases / etiology,  physiopathology,  therapy*
Obstetric Labor Complications / etiology,  physiopathology,  therapy*
Reflex, Abnormal*
Spinal Cord Injuries / complications

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