Epidural morphine bupivacaine combination for the control of autonomic hyperreflexia during labor

Abstract

The improvement in rehabilitation of young women with spinal cord lesions, combined with the fact that libido, fertility and child bearing remain intact, enables more such patients to conceive. The obstetric team is therefore bound to meet with such patients. Among the various complications of this condition during pregnancy is an acute life-threatening syndrome called autonomic hyperreflexia (AH), caused by an uncontrolled massive sympathetic discharge, which occurs in response to stimuli that reach the spinal cord below the lesion. Most authors agree that the best method of controlling AH during labor is by an epidural block which impends stimuli from reaching the spinal cord and thus provoking AH. Most authors could not completely abolish AH episodes using different medication epidurally. Herein we present a successful delivery using a combination of morphine bupivacaine epidurally. © 1994 S. Karger AG, Basel.