piperidines and Back-Pain

Spontaneous spinal-epidural hematoma is uncommon and rare during pregnancy. We were presented with a 31-year-old patient who developed back pain with lower extremity paralysis at 36 weeks of gestation. A magnetic resonance imaging scan demonstrated an acute spinal-epidural hematoma and therefore, an emergency cesarean delivery was performed followed by hemilaminectomy with hematoma removal. Anesthesia was initiated with a volatile-based technique which, following delivery of the baby, was changed to target-controlled infusions of propofol and remifentanil. Postoperatively, dopamine was infused to maintain the blood pressure within the high-normal range to optimize spinal cord perfusion. Successful anesthetic and postoperative management is described together with a review of the literature.

Topics: Adult; Androstanols; Anesthesia; Anesthetics, Inhalation; Anesthetics, Intravenous; Back Pain; Cesarean Section; Dopamine; Emergency Treatment; Female; Follow-Up Studies; Hematoma, Epidural, Spinal; Humans; Laminectomy; Magnetic Resonance Imaging; Methyl Ethers; Neuromuscular Nondepolarizing Agents; Paraplegia; Piperidines; Pregnancy; Pregnancy Complications; Propofol; Remifentanil; Rocuronium; Sevoflurane; Treatment Outcome

The measurement of diastasis of the spinous processes and of muscular action potentials by means of bio-feedback equipment is a clinically valid means to evaluate the extent of reflex muscular contracture. The methods were used to study the relaxant effect of pridinol mesylate on the lumbar extensor muscles in subjects with acute low back pain. It was found that pridinol mesylate significantly reduced the contracture of the extensor lumbar muscles in low back pain when given per os or parenterally.

Topics: Action Potentials; Back Pain; Biofeedback, Psychology; Contracture; Electrophysiology; Humans; Muscle Relaxation; Muscles; Piperidines; Posture

Topics: Back Pain; Contracture; Flatfoot; Humans; Low Back Pain; Mesylates; Muscle Relaxants, Central; Piperidines