Abstract | OBJECTIVE: CASE REPORT: A 38-year-old woman with MJD complicated by significant bulbar and peripheral neuropathy presented for an elective vaginal hysterectomy. She had no other medical history of note. After informed consent, subarachnoid block was performed by combined spinal- epidural anesthesia at the L2-3 lumbar intervertebral space with hyperbaric bupivacaine 12 mg, morphine 100 microg, and fentanyl 10 microg. Surgery proceeded uneventfully, with excellent postoperative analgesia. There was full recovery of preinduction neurologic function by the sixth postoperative hour. CONCLUSIONS: Central neuraxial anesthesia is an option for patients with MJD presenting for lower abdominal and lower extremity operations. Combined spinal- epidural anesthesia confers hemodynamic stability yet allows for augmentation of intraoperative anesthesia and postoperative analgesia.
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Authors | Alvin Y H Teo, Raymond W L Goy, Yeo Seow Woon |
Journal | Regional anesthesia and pain medicine
(Reg Anesth Pain Med)
2004 Jul-Aug
Vol. 29
Issue 4
Pg. 352-4
ISSN: 1098-7339 [Print] England |
PMID | 15305255
(Publication Type: Case Reports, Journal Article)
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Chemical References |
- Analgesics, Opioid
- Anesthetics, Combined
- Anesthetics, Local
- Morphine
- Fentanyl
- Bupivacaine
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Topics |
- Adult
- Analgesics, Opioid
(administration & dosage, therapeutic use)
- Anesthesia, Epidural
(methods)
- Anesthesia, Spinal
(methods)
- Anesthetics, Combined
(administration & dosage, therapeutic use)
- Anesthetics, Local
(administration & dosage, therapeutic use)
- Bupivacaine
(administration & dosage, therapeutic use)
- Female
- Fentanyl
(administration & dosage, therapeutic use)
- Humans
- Hysterectomy, Vaginal
(methods)
- Machado-Joseph Disease
(complications)
- Morphine
(administration & dosage, therapeutic use)
- Peripheral Nervous System Diseases
(complications)
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