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Intrathecal MorphineAka: ITM
- Indication
- Analgesia and Anesthesia for First Stage of Labor
- Gives four hours of Labor Anesthesia
- Mechanism of Action
- Acts at Opioid receptors
- Substantia gelatinosa of dorsal horn
- Affects afferent visceral pain impulses only
- Contrast with Epidural Anesthesia
- ITM does not affect second stage somatic pain
- ITM does not interfere with maternal pushing
- Does not inhibit efferent muscular paths
- Acts at Opioid receptors
- Labs
- Complete Blood Count with platelets
- Confirm no coagulopathy
- Complete Blood Count with platelets
- Technique
- Patient lying in lateral decubitus position or seated
- Spinal needle Insertion
- Site: L3-4 interspace
- Needle Gauge: 25 gauge ("Pencil point")
- Decreases Incidence of Postdural Puncture Headache
- Enter the dural sac as in Lumbar Puncture
- Clear Cerebrospinal Fluid should return promptly
- Instill Intrathecal medications
- Fentanyl 25 ug
- Morphine (preservative-free) 0.25 mg
- Monitoring
- Initial
- Blood Pressure, Pulse every 5 minutes for 30 minutes
- Respiratory Rate every 15 minutes for 1 hour
- Later
- Monitor hourly for 24 hours
- Naloxone by bedside for respiratory depression
- Initial
- Adverse reactions
- Maternal hypotension
- Nausea or Vomiting
- Pruritus
- Skin hypersensitivity
- Postdural Puncture Headache
- Reference
SLC22A18 gene (C1420135) | |
|---|---|
| Definition (NCI) | This gene plays a role in organic-cation transport and alterations in the gene have been associated with several cancers. |
| Concepts | Gene or Genome (T028) |
| English | BECKWITH-WIEDEMANN REGION 1A, BWR1A, BWSCR1A, IMPRINTED POLYSPECIFIC MEMBRANE TRANSPORTER 1, IMPT1, ITM, ORCTL2, ORGANIC-CATION TRANSPORTER-LIKE 2, SLC22A18, SLC22A18 gene, SLC22A1L, TSSC5, TUMOR-SUPPRESSING SUBCHROMOSOMAL TRANSFERABLE FRAGMENT CANDIDATE GENE 5 |
| Parent Concepts | Transport Protein Gene (C1336818) |
| Sources | HUGO, LNC, MTH, NCI, OMIM Derived from the NIH UMLS (Unified Medical Language System) |