EPIDURAL MORPHINE BUPIVACAINE COMBINATION FOR THE CONTROL OF AUTONOMIC HYPERREFLEXIA DURING LABOR

The improvement in rehabilitation of young women with spinal cord lesi ons, combined with the fact that libido, fertility and child bearing r emain intact, enables more such patients to conceive. The obstetric te am is therefore bound to meet with such patients. Among the various co mplications of this condition during pregnancy is an acute life-threat ening syndrome called autonomic hyperreflexia (AH), caused by an uncon trolled massive sympathetic discharge, which occurs in response to sti muli that reach the spinal cord below the lesion. Most authors agree t hat the best method of controlling AH during labor is by an epidural b lock which impends stimuli from reaching the spinal cord and thus prov oking AH. Most authors could not completely abolish AH episodes using different medication epidurally. Herein we present a successful delive ry using a combination of morphine bupivacaine epidurally.