Comparative assessment of mater dura permeability after labor and the efficacy of epidural analgesia with morphine after cesarean section
Vitenbek, I.A.
Anesteziologiya i Reanimatologiya 6: 63-66
1990
Accession: 007133706
Spinal dura mater permeability has been compared in 15 women dead in labor or of severe multiple combined traumas. The quantitative index for the assessment of transmeningeal morphine and dicaine diffusion was permeability coefficient calculated according to Fich's equation. It has been shown that in late pregnancy dura mater permeability for morphine and dicaine increases by 18.6% and 23.5%, respectively. However, a decrease of the diffusion barrier is not clinically manifested during epidural morphine analgesia due to an equivalent increase in the rate of intravascular opiate absorption. The conclusion is made that it is advisable to add the usual adrenaline dose (1:200,000) to the anesthetic solution to enhance the degree of anesthesia adequacy and to decrease the danger of the onset of general narcotic and respiratory depression on the fetus in the early neonatal period.