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Responses to mechanical and electrical stimuli are not attenuated by late pregnancy
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Posters
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Obstetric RA
204. Cesarean section and analgesic needs Fassoulaki A, Gatzou V, Petropoulos G, Siafaka I Email: [email protected] Aretaieion Hospital, Medical School University of Athens 76, Vas. Sophias Avenue 115 28, Greece Background. Pregnancy is associated with a higher spread of subarachnoid anaesthesia and increased pain threshold. The study was designed to assess the spread of subarachnoid block and the intraand postoperative analgesic requirements in pregnants vs nonpregnants. Methods. We assessed the level of subarachnoid anaesthesia after 1.8 ml of 5% hyperbaric lidocaine and the postoperative analgesic requirements in 30 women undergoing cesarean section and in 30 women undergoing abdominal hysterectomy. Intraoperatively epidural ropivacaine was given as required. All patients received 10 ml of 0.2% ropivacaine epidurally 2, 10 and 24 hours postoperatively and the VAS pain score was assessed. They also had access to PCA I.V. morphine. Results. Duration of surgery was 64 (13.7) vs 127 (33.8) min (p⬎0.0001) in the pregnant and nonpregrant groups. Ten minutes after subarachnoid injection, sensory blooc was higher by 3 dermatomes in pregnant group (p⬍0.0001). Time to first ropivacaine dose was 37 (19.7) vs 19 (12.2) min (p⬍0.001) and the ropivacaine normalized for the duration of anaesthesia was 0.8 (0.6) mg-1 vs 1.3 (0.5) mg-1 (p⫽0.001) in the pregnant and nonpregnant groups respectively. The time between the first and second ropivacaine dose was similar in the two groups (p⫽0.070). Fewer pregnant women (81 vs 100%) required ropivacaine intraoperatively (p⫽0.017). The VAS scores were similar but parturients consumed more I.V. morphine [33 (14) vs 24 (12) mg, p⫽0.016] during the forst 24 hours postoperatively. COnclusions. Pregnant patients exhibited a higher level of subarachnoid sensory block and required more I.V. morphine postoperatively.
205. Responses to mechanical and electrical stimuli are not attenuated by late pregnancy Fassoulaki A, Melemeni A, Petropoulos G, Siafaka I, Sarantopoulos C. Email: afassoul@otenet,gr Aretaieion Hospital, Medical School University of Athens, 76 Vas. Sophias Avenue, Athens 115 28, Greece Pregnancy has been associated with increased pain thresholds but only few studies in humans have shown increases in stimuli perception thresholds. This prospective crossover study compares the responses to standardized mechanical and electrical stimuli in pregnant women febore and four days after elective cesarean section. In a prospective crossover manner, 30 pregnant women scheduled for elective cesarean section under standardized regional anaesthesia, were subjected to mechanical stimuli, at a standardized pressure, and electrical stimuli, the amplitude of which were recorded. Stimuli were applied on both forearms and averaged. VAS scores as response to stimuli were recorded a day before and repeated four days after cesarean section. The response (VAS values) to mechanical stimuli obtained before cesarean section did not differ when compared to the VAS values obtained four days after cesarean section (16.3⫾14.4mm versus 12.8⫾12.5 mm respectively). Pain or discomfort experienced by the subjects due to electrical stimuli and expressed as VAS values was significantly higher before cesarean section when compared to four days afterthe cesarean section (35.3⫾20.0 mm and 28.3⫾19.7 mm respectively (p⫽0.006). These results do not support our hypothesis that late pregnancy is associated with antinociception in humans.
Posters
•
Obstetric RA
204. Cesarean section and analgesic needs Fassoulaki A, Gatzou V, Petropoulos G, Siafaka I Email: [email protected] Aretaieion Hospital, Medical School University of Athens 76, Vas. Sophias Avenue 115 28, Greece Background. Pregnancy is associated with a higher spread of subarachnoid anaesthesia and increased pain threshold. The study was designed to assess the spread of subarachnoid block and the intraand postoperative analgesic requirements in pregnants vs nonpregnants. Methods. We assessed the level of subarachnoid anaesthesia after 1.8 ml of 5% hyperbaric lidocaine and the postoperative analgesic requirements in 30 women undergoing cesarean section and in 30 women undergoing abdominal hysterectomy. Intraoperatively epidural ropivacaine was given as required. All patients received 10 ml of 0.2% ropivacaine epidurally 2, 10 and 24 hours postoperatively and the VAS pain score was assessed. They also had access to PCA I.V. morphine. Results. Duration of surgery was 64 (13.7) vs 127 (33.8) min (p⬎0.0001) in the pregnant and nonpregrant groups. Ten minutes after subarachnoid injection, sensory blooc was higher by 3 dermatomes in pregnant group (p⬍0.0001). Time to first ropivacaine dose was 37 (19.7) vs 19 (12.2) min (p⬍0.001) and the ropivacaine normalized for the duration of anaesthesia was 0.8 (0.6) mg-1 vs 1.3 (0.5) mg-1 (p⫽0.001) in the pregnant and nonpregnant groups respectively. The time between the first and second ropivacaine dose was similar in the two groups (p⫽0.070). Fewer pregnant women (81 vs 100%) required ropivacaine intraoperatively (p⫽0.017). The VAS scores were similar but parturients consumed more I.V. morphine [33 (14) vs 24 (12) mg, p⫽0.016] during the forst 24 hours postoperatively. COnclusions. Pregnant patients exhibited a higher level of subarachnoid sensory block and required more I.V. morphine postoperatively.
205. Responses to mechanical and electrical stimuli are not attenuated by late pregnancy Fassoulaki A, Melemeni A, Petropoulos G, Siafaka I, Sarantopoulos C. Email: afassoul@otenet,gr Aretaieion Hospital, Medical School University of Athens, 76 Vas. Sophias Avenue, Athens 115 28, Greece Pregnancy has been associated with increased pain thresholds but only few studies in humans have shown increases in stimuli perception thresholds. This prospective crossover study compares the responses to standardized mechanical and electrical stimuli in pregnant women febore and four days after elective cesarean section. In a prospective crossover manner, 30 pregnant women scheduled for elective cesarean section under standardized regional anaesthesia, were subjected to mechanical stimuli, at a standardized pressure, and electrical stimuli, the amplitude of which were recorded. Stimuli were applied on both forearms and averaged. VAS scores as response to stimuli were recorded a day before and repeated four days after cesarean section. The response (VAS values) to mechanical stimuli obtained before cesarean section did not differ when compared to the VAS values obtained four days after cesarean section (16.3⫾14.4mm versus 12.8⫾12.5 mm respectively). Pain or discomfort experienced by the subjects due to electrical stimuli and expressed as VAS values was significantly higher before cesarean section when compared to four days afterthe cesarean section (35.3⫾20.0 mm and 28.3⫾19.7 mm respectively (p⫽0.006). These results do not support our hypothesis that late pregnancy is associated with antinociception in humans.