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Updated: Aug 9, 2026

An Experimental Paradigm for the Prediction of Post-Operative Pain (PPOP)
Published on: January 28, 2010
Hyperventilation-induced tetany associated with epidural analgesia for labor
1Department of Anesthesiology, Perioperative and Pain Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02115, USA.
Abstract:
We report a case of painful carpo-pedal spasm associated with the initiation of epidural analgesia for labor. The patient, an otherwise healthy primigravida in early labor at term, was experiencing severe hyperventilation as a result of inappropriate use of the Lamaze breathing technique. Bilateral carpo-pedal spasm occurred, and produced severe pain. Resolution of symptoms coincided with onset of effective epidural labor pain relief. A diagnostic challenge was presented to the anesthesiologist, as the symptoms could have been consistent with subdural block, local anesthetic toxicity, high sensory level of analgesia or eclamptic neuro-excitation activity.
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