TY - JOUR
T1 - Paravertebral block for labor analgesia in a parturient with idiopathic thrombocytopenia
AU - Okutomi, Toshiyuki
AU - Taguchi, Masayuki
AU - Amano, Kan
AU - Hoka, Sumio
PY - 2002/10/1
Y1 - 2002/10/1
N2 - A parturient with idiopathic thrombocytopenia received labor analgesia with bilateral paravertebral blocks, because epidural analgesia was contraindicated due to her low platelet count (69,000·μl-1) even after intravenous administration of freeze-dried sulfonated human normal globulin (400 mg·kg-1·day-1) and transfusion of platelet (20 units·day-1). In spite of predonisolone (1 mg·kg-1·day-1) P.O., her platelet counts could not increase at early gestation period. Prior to the induction of the labor, two catheters were inserted into T 11 bilateral paravertebral spaces, then 0.2% ropivacaine 10 ml was administered in each side, followed by the infusion at 5 ml·hr-1 each for the management of first stage of labor pain. Labor was induced with oxytocin infusion at 2.5-5. 0 mU·min-1. As she requested additional analgesia in the second stage of labor, fentanyl 50 μg was administered twice intravenously. The labor course was uneventful with adequate analgesia, and the neonate (2,826 g) was vigorous with Apgar scores 9/10. Complications associated with this block such as hypotension, vascular or pleural punctures and pneumothorax were not seen. Bilateral paravertebral blocks may provide adequate analgesia as an alternative method for labor analgesia in a parturient with thrombocytopenia when conventional epidural analgesia is contraindicated.
AB - A parturient with idiopathic thrombocytopenia received labor analgesia with bilateral paravertebral blocks, because epidural analgesia was contraindicated due to her low platelet count (69,000·μl-1) even after intravenous administration of freeze-dried sulfonated human normal globulin (400 mg·kg-1·day-1) and transfusion of platelet (20 units·day-1). In spite of predonisolone (1 mg·kg-1·day-1) P.O., her platelet counts could not increase at early gestation period. Prior to the induction of the labor, two catheters were inserted into T 11 bilateral paravertebral spaces, then 0.2% ropivacaine 10 ml was administered in each side, followed by the infusion at 5 ml·hr-1 each for the management of first stage of labor pain. Labor was induced with oxytocin infusion at 2.5-5. 0 mU·min-1. As she requested additional analgesia in the second stage of labor, fentanyl 50 μg was administered twice intravenously. The labor course was uneventful with adequate analgesia, and the neonate (2,826 g) was vigorous with Apgar scores 9/10. Complications associated with this block such as hypotension, vascular or pleural punctures and pneumothorax were not seen. Bilateral paravertebral blocks may provide adequate analgesia as an alternative method for labor analgesia in a parturient with thrombocytopenia when conventional epidural analgesia is contraindicated.
UR - http://www.scopus.com/inward/record.url?scp=0036807418&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=0036807418&partnerID=8YFLogxK
M3 - Article
C2 - 12428320
AN - SCOPUS:0036807418
VL - 51
SP - 1123
EP - 1126
JO - Japanese Journal of Anesthesiology
JF - Japanese Journal of Anesthesiology
SN - 0021-4892
IS - 10
ER -