title: Histamine release following intrathecal administration of morphine for cesarean section.
abstract: We present a case of unusually profound, prolonged hypotension after induction of spinal anesthesia for cesarean section. The patient, a healthy parturient at 26 weeks gestation, received 0.75% bupivacaine, 15 mg and morphine, 0.15 mg by subarachnoid injection. Systolic blood pressure rapidly fell to below 80 mmHg despite left uterine displacement, 10 l of balanced saline solution, ephedrine 210 mg and phenylephrine 1000 microg. At the end of the operation we noted a pruritic, erythematous, circumscribed, raised rash, consistent with urticaria, over the patient's trunk, legs, arms and face. This rash persisted for 2 days. We postulate that the excessive hypotension following spinal anesthesia in this parturient was the result of intrathecal morphine induced histamine release.
authors.affiliation: Jefferson Medical College, Thomas Jefferson University, Philadelphia, Pennsylvania 19107, USA.
authors.forename: J E
authors.initials: JE
authors.lastname: Honet
authors.forename: M C
authors.initials: MC
authors.lastname: Norris