Articles: analgesia.
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J Gynecol Obst Bio R · Jan 1995
Case Reports[Spontaneous rupture of an unscarred uterus during labor and epidural anesthesia].
We report a case of spontaneous rupture of unscarred uterus, during labour and under epidural analgesia in a 43 year-old patient at her third pregnancy and third delivery. The tear was vertical and took place on the left postero-lateral side of the uterus, occurring in the whole height of the lower segment and overlapping towards the uterine corpus and cervix. Analysis of medical, surgical, gynaecological and obstetrical past history has displayed no predisposing factors explaining this rare occurrence. This clinical case reminds us that spontaneous rupture is always possible even on an unscarred uterus.
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Analgesic pharmacotherapy represents one of the major approaches to the treatment of cancer pain, since it is used in almost every patient. A thorough evaluation of the physical and mental status of the patient and of the pain is as necessary as a sound understanding of the pharmacokinetic and pharmacodynamic characteristics of the analgesics selected. The World Health Organization (WHO) has issued a basic 3 stage progression for the treatment of cancer pain, the "WHO Analgesic Ladder". ⋯ The most common of these is constipation; nausea, vomiting and sedation occur mostly at the start and can usually be treated effectively. The appropriate dosage, route of administration and dosage scheme of analgesics needs to be worked out for each individual patient in intensive work with the patient and a close follow-up, for years if necessary. Some analgesics may not be available in some countries, or only in specific preparations.