Masui. The Japanese journal of anesthesiology
-
Case Reports
[A case of vertebral metastasis revealed by incomplete spinal analgesia for cesarean section].
A 36-year-old woman was scheduled for Cesarean section under spinal anesthesia. She was a carrier of hepatitis-B-virus and diabetic. She was complaining of low back pain. ⋯ After the delivery, she still complained of low back pain. Later examination revealed metastatic bone tumor of L2 from hepatoma. This case suggests that in a patient with such incomplete spinal or epidural anesthesia and neurological finding, vertebral metastatic tumor should be ruled out.
-
To evaluate postoperative analgesia and side effects of epidural buprenorphine, 100 patients who underwent upper abdominal surgery were divided into 5 groups. All patients were given initially 0.1 mg of buprenorphine in 8 ml of 0.25% bupivacaine in bolus. Following an epidural bolus, 20 patients in each group were given 0.25% bupivacaine alone (group A), 5 micrograms buprenorphine in 1 ml of 0.25% bupivacaine (group B), 8 micrograms buprenorphine in 1 ml of 0.25% bupivacaine (group C), 12 micrograms buprenorphine in 1 ml of 0.25% bupivacaine (group D), or 15 micrograms buprenorphine in 1 ml of 0.25% bupivacaine (group E) with a portable disposable device at a rate of 1 ml.h-1 for 48 h. ⋯ No significant difference was found in the incidence of side-effect among 5 groups. Therefore, epidural buprenorphine 15 micrograms in 1 ml of 0.25% bupivacaine given to patients at a rate of 1 ml.h-1 was thought to be optimal for postoperative pain relief in upper abdominal surgery in terms of its efficacy and side effects. However, 35% of these patients required supplementary systemic analgesics in the early postoperative period.