Safety and Efficacy of Epinephrine and Morphine Added to Bupivacaine for Lumbar Epidural Anesthesia in Obstetrics / 대한마취과학회지

The effects of epidural bupivacaine with and without epinephrine and morphine on mat-ernal blood pressure, newborn Apgar scores, and duration of analgesia were compared in 40 parturients during Cesarean section and post operative periods. Patients in group 1(n= 16) received 0.5% bupivacaine 27cc and group 2(n=10) recelved bupivacaine with epinephrine, group 3 (n= 10) received bupivacaine with morphine 3mg, and those in group 4(n= 10) received bupivacaine with epinephrine and morphine 3mg. Maternal hypotension occured less frequently in group 2 than in group 1 (p<0.001). Apgar scores were equally good (more than 8) all four groups. Duration of analgesia was longer in group 2(199.50+/-70.73min) than in group 1(133.50+/-50. 11min) but significantly longer in group 3(471.50+/-174.90) and in group 4(684.00+/-276. 92min) . It is concluded that adding epinephrine and morphine to bupivacaine during epidural anesthesia in the normal parturient has no adverse effects on either mother or neonate; and that it significantly prolongs the duration of analgesia and decreases the incidence of maternal hypotension.

Postoperative Pulmonary Edema Scondary to Laryngospasm / 대한마취과학회지

Acute pulmonary edema associated with intense laryngospasm during or after anesthesia seems to be a rare complication. Although emergency reestablishment of the airway may avert fatal hypoxia, subsequent morbidity may follow from the delayed effects of the obstruction. We recently observed a 16-year-old, 5kg boy, with inguinal hernia who developed laryngospasm and pulmonary edema following a herniorrhaphy and he had no evidence of cardiac enlargement or cardiovascular disease.