[A case of continuous epidural anesthesia for pain relief in a pregnant woman with uterine myoma in the second trimester of pregnancy].

We present a case of continuous epidural anesthesia for a pregnant woman with uterine myoma. A 35-year-old pregnant woman at 16 weeks of pregnancy became aware of pain in the right lower abdomen. She was diagnosed with painful degenerating uterine myoma. Acetaminophen failed to control pain, and intramuscular pentazocine was only weakly effective. To avoid increasing the analgesic dose, we resorted to continuous epidural anesthesia starting at 18 weeks of pregnancy. The pain was improved remarkably by continuous epidural anesthesia with 0.2% ropivacaine. The epidural catheter was removed 6 days after the initiation of treatment. Since then there was no recurrence of pain. Besides providing good analgesic effect, the epidural anesthesia can help suppress uterine contractions and improve blood flow to the myomatous parts of the uterus. Therefore, it can be a suitable method of pain control in women with uterine myomas in mid-pregnancy.