title: [Pain control by caudal epidural infusion in a pregnant woman with hemorrhoids carrying triplets].
abstract: A 30-year-old woman in her 25th week of gestation with triplets complained of severe pain due to a hemorrhoid. The patient felt it was difficult to continue childbearing. First we performed caudal epidural block with 0.25% bupivacaine 20 ml and morphine hydrochloride 2 mg once a day, for 12 days without inserting a catheter because there were signs of infection. After the signs of infection had disappeared, we inserted a caudal epidural catheter and administered 0.125% bupivacaine 1-2 ml x hr(-1) for 6 days, up to the day of cesarean section. Liver function and blood bupivacaine levels of the mother were acceptable in the perioperative periods. The babies' Apgar scores and neurologic findings of the babies were normal. Blood bupivacaine levels of the babies were below the limit of measurement.
authors.affiliation: Department of Anesthesiology, Kobe Children's Hospital, Kobe 654-0081.
authors.forename: Reiko
authors.initials: R
authors.lastname: Uokawa
authors.forename: Takeshi
authors.initials: T
authors.lastname: Suzuki
authors.forename: Tetsuro
authors.initials: T
authors.lastname: Kagawa
mesh_terms: D000328:Adult; D015360:Analgesia, Epidural / Q000379:methods*; D000763:Anesthesia, Caudal / Q000379:methods*; D005260:Female; D006484:Hemorrhoids / Q000628:therapy*; D006801:Humans; D059408:Pain Management; D011247:Pregnancy; D011248:Pregnancy Complications / Q000628:therapy*; D011272:Pregnancy, Multiple; D014310:Triplets