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Canadian Journal of Anesthesia, Vol 42, 1134-1136, Copyright © 1995 by Canadian Anesthesiologists' Society

ARTICLES

Autonomic hyperreflexia during labour

A Kobayashi, T Mizobe, H Tojo and S Hashimoto
Department of Anesthesiology, Kyoto Prefectural University of Medicine, Japan.

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.




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Copyright © 1995 by the Canadian Anesthesiologists' Society.