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.[19]
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 (18).
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.
[14] After the first article on
spinal analgesia using opioids written by Yaksh and Rudy in 1976, [7] the neuraxial route to inject opioids as adjuvant drugs grew logarithmically.
