Hyperbaric intrathecal morphine analgesia during labor in a patient with Wolff-Parkinson-White syndrome.

The Wolff-Parkinson-White syndrome can complicate the anesthetic management of the pregnant patient. These patients are prone to arrhythmia that can be accompanied by hypotension. Maintenance of a stable heart rhythm is necessary for both maternal and fetal well-being.

Effect of intrathecal morphine during labor on maternal plasma beta-endorphin levels.

Plasma beta-endorphin was measured in 16 patients in labor prior to and after complete onset of analgesia with 1 mg of morphine administered intrathecally. Human beta-endorphin levels were determined by radioimmunoassay following silicic acid extraction of plasma samples and separation of the beta-endorphin fraction by gel chromatography. Plasma beta-endorphin levels decreased significantly (p less than 0.

Epidural morphine analgesia after cesarean delivery.

The effectiveness and safety of 5 mg of epidurally administered morphine for postoperative analgesia was determined in 276 healthy women undergoing cesarean delivery. Overall pain relief, time to administration of additional analgesic medications, and adverse side effects were evaluated. Epidural injection of 5 mg of morphine provided good to excellent pain relief lasting 24 to 36 hours for 83% of patients.

Bupivacaine-induced cardiac arrhythmias in sheep.

Controversy persists about the cardiac toxicity of bupivacaine if accidentally administered intravenously during regional anesthesia. Using awake, unanesthetized sheep, we evaluated the cardiac effects of low and high equivalent doses of lidocaine and bupivacaine given intravenously over 10 s. All animals convulsed within 30 s of injections.