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Abstract

A 27-year-old nullipara, 38 weeks pregnant, was admitted for elective cesarean section under spinal anesthesia. Past medical history was unremarkable. Spinal anesthesia was performed with 10 mg of 0.5% heavy bupivacaine. Ephedrine 10 mg was added to Ringer solution for prevention of hypotension. Hemodynamic parameters were normal and stable during surgery. Several hours later, the patient asked for analgesic drug and two 100mg diclofenac suppositories were administered. Three hours later, the patient suffered from an extensive and cramping abdominal pain. The pain was located in the right upper quadrant and radiated to the right infrascapular region. Electrocardiogram obtained was normal. Intravenous pantoprazole and oral anti-acid were administered, but no decease in pain was seen after fifteen minutes. Subsequently, a sublingual nitoglycerine perle was administered and the intensity of pain was decreased significantly. The diagnosis of Oddi spasm was assumed.