title: Regional anaesthesia for repeat Caesarean section in a patient with phantom limb pain.
abstract: The triggering of phantom limb pain by subarachnoid or epidural anaesthesia has been well described leading to the suggestion that neuraxial regional anaesthesia is relatively contraindicated in lower limb amputees. We report our experience of the provision of anaesthesia for repeat Caesarean section on two occasions in such a patient. Intrathecal fentanyl and morphine supplementation of bupivacaine successfully abolished peri-operative phantom limb pain, whereas epidural anaesthesia was associated with recurrence of phantom limb pain upon regression of the block.
authors.affiliation: Nuffield Department of Anaesthetics, John Radcliffe Hospital, Headington, Oxford.
authors.forename: D R
authors.initials: DR
authors.lastname: Uncles
authors.forename: C J
authors.initials: CJ
authors.lastname: Glynn
authors.forename: L E
authors.initials: LE
authors.lastname: Carrie
mesh_terms: D000328:Adult; D000701:Analgesics, Opioid; D000765:Anesthesia, Conduction; D000767:Anesthesia, Epidural / Q000009:adverse effects; D000773:Anesthesia, Obstetrical; D000779:Anesthetics, Local; D002045:Bupivacaine; D017604:Cesarean Section, Repeat; D005260:Female; D005283:Fentanyl; D006801:Humans; D009020:Morphine; D010146:Pain / Q000139:chemically induced / Q000517:prevention & control*; D010591:Phantom Limb / Q000150:complications*; D011247:Pregnancy
chemical_list: D000701:Analgesics, Opioid; D000779:Anesthetics, Local; D009020:Morphine; D005283:Fentanyl; D002045:Bupivacaine