Acta anaesthesiologica Scandinavica
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Acta Anaesthesiol Scand · Oct 1998
Case ReportsIs development of hyperalgesia, allodynia and myoclonus related to morphine metabolism during long-term administration? Six case histories.
Recently, clinical reports have suggested a relationship between the occurrence of hyperalgesia, allodynia and/or myoclonus and treatment with high doses of morphine in humans. Although few clinical descriptions of these phenomena are available, experimental work supports the notion that high doses of morphine may play a pathogenetic role in the observed behavioural syndrome. ⋯ These results may indicate that elevated concentrations of M-3-G in plasma as well as the plasma and CSF M-3-G/M-6-G ratios may play a pathogenetic role in the development of hyperalgesia, allodynia and myoclonus.
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Acta Anaesthesiol Scand · Oct 1998
Case ReportsCombined spinal and epidural anesthesia for cesarean section in a parturient with moyamoya disease.
We present the case of a parturient with moyamoya disease admitted to the hospital for elective cesarean section. Combined spinal and epidural technique was chosen because it allows better analgesia than epidural anesthesia and more hemodynamic stability than either general or spinal anesthesia. Ropivacaine was the local anesthetic of choice for the epidural portion because of the wide sensory-motor dissociation, thus preserving adequate respiration in the case of a high block.