Advantage of the paramedian approach for lumber spinal analgesia
a clinical comparison between midline and paramedian approaches.
Moreover, the addition of spinal analgesia
did not affect the quality of the block, side effects, or patient satisfaction with analgesia, Dr.
This phenomenon has also been noted when women requesting epidural analgesia are compared with those not requesting spinal analgesia
The addition of Morphine prolongs fentanyl-bupivacaine spinal analgesia
for the relief of labor pain.
In a study which investigated the the effect of spinal analgesia
with 50 micrograms fentanyl on stages of labor in nulliparous women, they reported no differences between the different stages of labor; however, the samples were smaller and induced labor was observed.
Wongyingsinn et al (2012) have shown in a randomised controlled trial that spinal analgesia
with morphine combined with bupivacaine for laparoscopic colonic resection provide better analgesia and decreases postoperative opioid requirement than those treated with intravenous opioid PCA.
The onset of hypotension, nausea and shivering shortly after intrathecal injection of local anaesthetic drugs and later development of PDPH and backache are iatrogenic morbidities commonly seen after spinal analgesia
Hence, interference by residual effect of intraoperative analgesia or spinal analgesia
is ruled out.
Continuous spinal analgesia
should be unaffected by extensive disruption of the epidural space and prolong analgesia duration beyond that of a single-dose intrathecal morphine injection.
Intrathecal clonidine prolonged the duration of spinal analgesia
, but was markedly inferior to the intrathecal morphine in providing subsequent postoperative analgesia.
Morphine is administered intrathecally alone or in combination with other drugs to provide spinal analgesia
. Dose-finding studies have recommended 100 [micro]g be used intrathecally to optimise analgesia and minimise side-effects for caesarean section and hip replacement surgery.
 After the first article on spinal analgesia
using opioids written by Yaksh and Rudy in 1976,  the neuraxial route to inject opioids as adjuvant drugs grew logarithmically.