{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T16:43:59Z","timestamp":1787071439407,"version":"build-2736575974"},"reference-count":23,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"3","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2014,7]]},"abstract":"<jats:p>A 32-year-old Indian female 38 weeks pregnant, with a history of multiple sclerosis since 2008 was admitted in obstetric ward for safe confinement. She had a history of diminution of vision in both eyes and limb weakness, relapsing \u2013 remitting type with movement-induced muscle spasms, in all the four limbs. Her symptoms were usually diplopia, difficulty in vision and ataxic gait. Sh was then treated with methylprednisolone. She was on oral dimethyl fumarate trial, which was stopped at the beginning of pregnancy. Presently, she was completely asymptomatic. Epidural anesthesia with an indwelling catheter was administered with 15 ml of 0.25% bupivacaine in 5 ml increments. A total of 3 mg of epidural morphine was given for post-operative analgesia. The surgery evolved without any intercurrences and patient was discharged from the hospital 72 h after surgery without worsening of her symptoms. We report a safe anesthetic management of a patient with MS undergoing cesarean section with low dose epidural bupivacaine with the addition of morphine for post-operative analgesia.<\/jats:p>","DOI":"10.4103\/1658-354x.136633","type":"journal-article","created":{"date-parts":[[2014,7,10]],"date-time":"2014-07-10T08:33:25Z","timestamp":1404981205000},"page":"402-405","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":8,"title":["Anesthetic management of a patient with multiple sclerosis undergoing cesarean section with low dose epidural bupivacaine"],"prefix":"10.4103","volume":"8","author":[{"given":"Sameer","family":"Sethi","sequence":"first","affiliation":[{"name":"Department of Anesthesia and Intensive Care, Post Graduate Institute of Medical Education and Research, Chandigarh, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sonia","family":"Kapil","sequence":"additional","affiliation":[{"name":"Department of Anesthesia and Intensive Care, Post Graduate Institute of Medical Education and Research, Chandigarh, India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"R3-20250926","doi-asserted-by":"crossref","first-page":"301","DOI":"10.1590\/S0034-70942007000300008","article-title":"Subarachnoid anesthesia for cesarean section in a patient with multiple sclerosis: Case report","volume":"57","author":"Barbosa","year":"2007","journal-title":"Rev Bras Anestesiol"},{"key":"R5-20250926","doi-asserted-by":"crossref","first-page":"454","DOI":"10.1007\/BF03016521","article-title":"Neuraxial anesthesia and multiple sclerosis","volume":"52","author":"Perlas","year":"2005","journal-title":"Can J Anaesth"},{"key":"R6-20250926","first-page":"91","article-title":"Anesthesia for multiple sclerosis in a patient undergoing correction of ASD \u2014 A case report","volume":"15","author":"al Satli","year":"1999","journal-title":"Middle East J Anesthesiol"},{"key":"R8-20250926","first-page":"334","article-title":"Multiple sclerosis and anesthesia","volume":"44","author":"Iglesias-Gonz\u00e1lez","year":"1997","journal-title":"Rev Esp Anestesiol Reanim"},{"key":"R9-20250926","doi-asserted-by":"crossref","first-page":"1022","DOI":"10.1213\/00000539-198212000-00014","article-title":"Lumbar epidural anesthesia in a patient with multiple sclerosis","volume":"61","author":"Warren","year":"1982","journal-title":"Anesth Analg"},{"key":"R10-20250926","doi-asserted-by":"crossref","first-page":"359","DOI":"10.4097\/kjae.2010.59.5.359","article-title":"Anesthetic management of the emergency laparotomy for a patient with multiple sclerosis \u2014 A case report","volume":"59","author":"Lee","year":"2010","journal-title":"Korean J Anesthesiol"},{"key":"R11-20250926","doi-asserted-by":"crossref","first-page":"493","DOI":"10.1007\/BF03016529","article-title":"Prolonged duration of anesthesia in a patient with multiple sclerosis following paravertebral block","volume":"52","author":"Finucane","year":"2005","journal-title":"Can J Anaesth"},{"key":"R12-20250926","doi-asserted-by":"crossref","first-page":"640","DOI":"10.1111\/j.1365-2044.1990.tb14387.x","article-title":"Intrathecal diamorphine during laparotomy in a patient with advanced multiple sclerosis","volume":"45","author":"Leigh","year":"1990","journal-title":"Anesthesia"},{"key":"R13-20250926","doi-asserted-by":"crossref","first-page":"831","DOI":"10.1111\/j.1399-6576.2007.01325.x","article-title":"Anaesthetic considerations for patients with a pre-existing neurological deficit: Are neuraxial techniques safe?","volume":"51","author":"Vercauteren","year":"2007","journal-title":"Acta Anaesthesiol Scand"},{"key":"R14-20250926","doi-asserted-by":"crossref","first-page":"223","DOI":"10.1213\/01.ane.0000220896.56427.53","article-title":"Neuraxial anesthesia and analgesia in patients with pre-existing central nervous system disorders","volume":"103","author":"Hebl","year":"2006","journal-title":"Anesth Analg"},{"key":"R15-20250926","first-page":"458","article-title":"A 12-month follow-up for neurological complication after subarachnoid anesthesia in a parturient affected by multiple sclerosis","volume":"15","author":"Martucci","year":"2011","journal-title":"Eur Rev Med Pharmacol Sci"},{"key":"R16-20250926","article-title":"Anesthetic management of pregnant patient with multiple sclerosis","volume":"28","author":"Malhotra","year":"2011","journal-title":"Internet J Anesthesiol"},{"key":"R17-20250926","doi-asserted-by":"crossref","first-page":"365","DOI":"10.1097\/00001503-200206000-00015","article-title":"Multiple sclerosis and anesthetic implications","volume":"15","author":"Dorotta","year":"2002","journal-title":"Curr Opin Anaesthesiol"},{"key":"R18-20250926","doi-asserted-by":"crossref","first-page":"64","DOI":"10.4103\/0019-5049.76598","article-title":"Anaesthetic management in a patient with multiple sclerosis","volume":"55","author":"Kulkarni","year":"2011","journal-title":"Indian J Anaesth"},{"key":"R19-20250926","doi-asserted-by":"crossref","first-page":"499","DOI":"10.1378\/chest.98.2.499","article-title":"Diaphragmatic paralysis without bulbar or limb paralysis in multiple sclerosis","volume":"98","author":"Aisen","year":"1990","journal-title":"Chest"},{"key":"R20-20250926","doi-asserted-by":"crossref","first-page":"479","DOI":"10.1378\/chest.101.2.479","article-title":"Respiratory function in multiple sclerosis. Utility of clinical assessment of respiratory muscle function","volume":"101","author":"Smeltzer","year":"1992","journal-title":"Chest"},{"key":"R21-20250926","first-page":"1083","article-title":"Epidural anesthesia for cesarean section in a patient with von Hippel-Lindau disease and multiple sclerosis","volume":"88","author":"Wang","year":"1999","journal-title":"Anesth Analg"},{"key":"R22-20250926","doi-asserted-by":"crossref","first-page":"165","DOI":"10.1186\/1471-2377-12-165","article-title":"Epidural analgesia and cesarean delivery in multiple sclerosis post-partum relapses: The Italian cohort study","volume":"12","author":"Past\u00f2","year":"2012","journal-title":"BMC Neurol"},{"key":"R23-20250926","doi-asserted-by":"crossref","first-page":"21","DOI":"10.1016\/0952-8180(88)90006-2","article-title":"Anesthesia for the obstetric patient with multiple sclerosis","volume":"1","author":"Bader","year":"1988","journal-title":"J Clin Anesth"},{"key":"R25-20250926","doi-asserted-by":"crossref","first-page":"861","DOI":"10.1016\/j.annfar.2003.08.005","article-title":"Obstetrical analgesia and anesthesia in multiple sclerosis","volume":"22","author":"Dalmas","year":"2003","journal-title":"Ann Fr Anesth Reanim"},{"key":"R26-20250926","doi-asserted-by":"crossref","first-page":"837","DOI":"10.1097\/00000542-198706000-00025","article-title":"Measurement of acetylcholine receptor concentration in skeletal muscle from a patient with multiple sclerosis and resistance to atracurium","volume":"66","author":"Brett","year":"1987","journal-title":"Anesthesiology"},{"key":"R27-20250926","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/0022-510X(94)00248-M","article-title":"Influence of temperature changes on multiple sclerosis: Critical review of mechanisms and research potential","volume":"129","author":"Guthrie","year":"1995","journal-title":"J Neurol Sci"},{"key":"R28-20250926","doi-asserted-by":"crossref","first-page":"315","DOI":"10.1016\/j.thromres.2009.06.023","article-title":"Risk of deep venous thrombosis (DVT) in bedridden or wheelchair-bound multiple sclerosis patients: A prospective study","volume":"125","author":"Arpaia","year":"2010","journal-title":"Thromb Res"}],"container-title":["Saudi Journal of Anaesthesia"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/01437113-201408030-00022","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T15:46:11Z","timestamp":1787067971000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/01437113-201408030-00022"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2014,7]]},"references-count":23,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2014]]}},"URL":"https:\/\/doi.org\/10.4103\/1658-354x.136633","relation":{},"ISSN":["1658-354X","0975-3125"],"issn-type":[{"value":"1658-354X","type":"print"},{"value":"0975-3125","type":"electronic"}],"subject":[],"published":{"date-parts":[[2014,7]]}}}