• Junichi Haruna, Akihiro Taniguchi, Keiko Kinouchi, Kazuo Fukumitsu, Yoshikazu Miyamoto, Seiji Kitamura, and Daisuke Hiramatsu.
• Department of Anesthesiology, Osaka Medical Center, Research Institute for Maternal and Child Health, Izumi 594-1101.
• Masui. 2003 Sep 1;52(9):981-3.

AbstractWe report a case of primipara with triplet pregnancy who underwent combined spinal and epidural anesthesia 10 weeks after epidural blood patch. At 15 weeks of gestation, a woman with triplet gestation underwent Shirodkar operation under spinal anesthesia and subsequent epidural blood patch as a treatment of post-dural puncture headache. At 26 weeks she presented with acute abdomen and laparotomy was scheduled. Spinal anesthesia was selected with an epidural catheter inserted in case of prolonged operation and for postoperative pain control. The placement of an epidural catheter was without problem. Laparotomy revealed right paraovarian cyst torsion and the right salpingo-paraoophocystectomy was performed. Patient-controlled analgesia with epidural bupivacaine and fentanyl was effectively continued for two days. Postoperative course was uneventful and the triplets were delivered by cesarean section at 35 weeks.

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