AUTONOMIC HYPERREFLEXIA DURING LABOR

We present two cases of automatic hyperreflexia (AH) during labour in women with spinal cord damage, in whom AH developed before and after d elivery. The AH was successfully controlled using epidural anaesthesia in Case #1, but failed in Case #2. The blood pressure was controlled with nicardipine. However, overdose of nicardipine produces vasodilata tion and its side effects include headache, flushing and palpitation s imilar to AH.(1) Considering these effects, we recommend epidural anae sthesia to control AH, because epidural anaesthesia does not only redu ce BP, but also blocks the noxious stimuli and relieves the symptoms o f AH. Our experience suggests that the epidural catheter can be placed two to three weeks before the date of predicted childbirth, because t he onset of labour in a patient with spinal cord damage is difficult t o predict and can proceed very rapidly. Also the epidural catheter is available after the delivery. We recommended the epidural catheter is maintained for 24-48 hr postpartum.