Continuous Infusion of Bupivacaine for Analgesia during Labor

Isoxsuprine (ISOX) is a potent effective in suppressing premature with ISOX we identified seven (0.6% either prepartum in five or immedia uterine muscle relaxant and often abor. Of 1276 cases requiring tocolysis who developed acute pulmonary edema (PE) ely following delivery in two. None had co-existent heart disease. ISOX was given as an IV infusion (avg. 0.41 mg/min) for 1.5 to 9.4 days with an average total dose of 1.8 gm. Four patients received alcohol infusion which was discontinued 24 hr. before PE in all but one patient. Four patients received steroids. To prevent ISOX induced hypotension, all patients received IV fluids (avg. 3.57 L/day). There was an average hemoglobin dcclinc of 1.3 gm/dl during ISOX infusion. The PE was raPidly reversed with oxygen, bed rest and IV diuretics. Diqoxin was required in three patients. This study indicates that intravenous ISOX and volume loading can precipitate PE in about one-half per cent of otherwise healthy women durinq preterm labor.