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regional vs general with toxemiaFrom: Robert Brenner (robbrenner@earthlink.net)Thu Mar 28 14:31:21 1996
>Pre-toxemic (do you use that term anymore?) patients have a >substantially lowered seizure threshold. Epidural anal*ge*sia rarely >pushes that threshold in terms of local anesthetic dosage. Epidural >an*esthe*sia crowds that limit to the max. I have never seen the term "pre-toxemic." Also, I don't see how epidural can alter the seizure thresshold in a patient. It is my understanding that the big concern with regional anesthesia is the risk of rapid BP drop with subsequent uteroplacental insufficiency and this is more likely with spinal than epidural. The type of anesthesia and seizure prevention are two independent variables (unless the patient is in status epilepticus).
-- Robert Brenner MD FACOG Baltimore MD Robbrenner@earthlink.net
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