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There was profound respiratory depression 100 minutes after the administration of fentanyl 100 micrograms epidurally (192), whilst epidural sufentanil caused apnea within a couple of minutes, reversed by nalbuphine (193). Epidural buprenorphine 150 micrograms produced prolonged timedependent biphasic depression of carbon dioxide response in six healthy volunteers. The second maximum occurred at 8–10 hours after injection (194). Similar cases have been reported by others. 5-year-old child had been given a caudal epidural of 100 micrograms/kg of morphine (195).

21 Epidural needle or catheter misplacement are complications justifying the need for an epidural test dose. The reliability of the epidural test dose has been reviewed (186). Postoperative epidural analgesia has been compared with postoperative patient-controlled intravenous analgesia following radical retropubic prostatectomy in 60 patients (187). The epidural techniques gave better pain management. Significantly more patients who received epidural morphine required antiemetics and maximum expiratory pressure was significantly lower at 4 and 24 hours in those whose received it by PCA.

Finnegan LP. Pulmonary problems encountered by the infant of the drug-dependent mother. Clin Chest Med 1980;1(3):311–25. 105. Ghodse AH, Reed JL, Mack JW. The effect of maternal narcotic addiction on the newborn infant. Psychol Med 1977;7(4):667–75. 106. Olofsson M, Buckley W, Andersen GE, Friis-Hansen B. Investigation of 89 children born by drug-dependent mothers. I. Neonatal course. Acta Paediatr Scand 1983;72(3):403–6. 107. Rosen TS, Johnson HL. Children of methadone-maintained mothers: follow-up to 18 months of age.

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Cardiology [Blueprints - Notes and Cases] by E. Awtry, et al.,


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