Re: Pitocin and epidural

From: R. Daniel Braun (rd.braun@gmail.com)
Tue May 31 19:23:01 2005


Way back in the 70's Frank Griess at Bowman-Gray did a study in ewes showing that exposure of the uterine artery to caine drugs caused it to spasm, and then the uterus contracted tetanically and the fetal heart rate went down for 8-10 minutes and recovered. About 2-3 years later Charles P. Gibbs, then in Florida, took human uterine artery segments obtained from cesarean hysterectomy specimens would also contract when exposed to low concentrations of caine drugs in a water bath. Both by the way OB's, Dr. Gibbs however is also an anesthesiologist and practices that specialty. As far as I know, this is the only evidence.

On 5/31/05, RModugno@aol.com <RModugno@aol.com> wrote: >
> In a message dated 5/31/2005 4:48:07 PM Eastern Standard Time,
> ainsron@sbcglobal.net writes:
>
> What I want to know is the list member's opinion on this question: Is
> there EBM that supports my anesthesiologist's assertion that standard of
> care in 2005 is that pitocin should be turned off before he can start an
> epidural and for 30 minutes after the epidural has setup?
>
> Hmmm, at our hospital where everyone is on pitocin and virtually everyone
> gets an epidural we have no such 'rule' but, we seem to have a heck of a lot
> of fetal heart rate abnormalities round about the time of epidural
> insertion. By golly, the anesthesiologist might have something! I wouldn't
> discount information from their meetings as anecdotal - but getting some EBM
> would be good! I'll ask our anesthesiologists.
> Robert Modugno MD MBA FACOG
> Marietta, GA
>

--
R. Daniel Braun
Kinky for Governor




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