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Re: Subject: Section on demand From: Myer S. Bornstein (mborn@massmed.org) Sat Apr 29 07:04:41 2006 Messages sorted by: [ date ][ thread ][ subject ][ author ] Next message: Jim Lie: "Re: Bisphosphonates" Previous message: Dr. John Provatopoulos B.Sc. M.D.C.M. F.R.S.C.: "Re: Subject: Section on demand" In reply to: Efrain Ramirez: "Re: Subject: Section on demand" Next in thread: Dr. John Provatopoulos B.Sc. M.D.C.M. F.R.S.C.: "Re: Subject: Section on demand" My patients post c/s or abdominal surgery, with either PCA or a Duramorph (morphine analogue) spinal get a low residual diet the first 24 hours the diet as tolerated and ambulates ASAP. The literature supports this and I have had a lower incidence of ilieus. Having seen Post spinal HA in patients with a single puncture, 27 gauge needle and no HA with multiple punctures and a 21 gauge needle. I think it is all luck. But remember to rule out other causes for the Headache Myer -- Myer S. Bornstein, MD, MMM, FACOG, FACPE -----Original Message----- From: ob-gyn-l@obgyn.net [mailto:ob-gyn-l@obgyn.net] On Behalf Of Efrain Ramirez Sent: Friday, April 28, 2006 1:10 PM To: Multiple recipients of list OB-GYN-L Subject: Re: Subject: Section on demand I was raised in the neighborhood of bed rest for at least 12 hours, NPO, then clear liquids, etc. - it has become clear to me through reading and experience that such guidelines are of no benefit -nowadays is early ambulation and regular diet - no regrets - I think post spinal headaches has to do more with technique, needle size and experience of the anesthesiologist- and of course good luck.. years ago during my residency a guy was doing a spinal - he was very nervous and he punctured the lady oh. I don't know how many times - he finally succeeded, looked at me and proudly asked - "Did you like my acupuncture technique"? - we all laughed - including the patient.. Ef At Fri, 28 Apr 2006, Dr Eberhard Lisse wrote: > >So far the only ones that had a headache were the ones to listen to the >anesthetists and stay 12 hours in bed. And they all tell me that this is >not something they would wish onto their worst enemy... > >And the one anesthetist I know who had a spinal herself, recommends 24 >hours :-)-O > >el > >on 4/28/06 3:19 PM Meenan, Anna said the following: >> No, but what has that got to do with knowing how (or how not) to prevent >> one? No one has answered Richard's original question of why 24 hrs of >> bedrest after a spinal. >> >> Anna Meenan, MD >> >>> Have you ever *HAD* one? -- " The greatest obstacle to knowledge is not ignorance, it is the illusion of knowledge." Daniel J. Boorstin - Historian Next message: Jim Lie: "Re: Bisphosphonates" Previous message: Dr. John Provatopoulos B.Sc. M.D.C.M. F.R.S.C.: "Re: Subject: Section on demand" In reply to: Efrain Ramirez: "Re: Subject: Section on demand" Next in thread: Dr. John Provatopoulos B.Sc. M.D.C.M. F.R.S.C.: "Re: Subject: Section on demand"

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