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Low back pain is common during pregnancy and has been reported in as many as 56% of pregnant women. However, the incidence of symptomatic lumbar disc displacement in pregnancy is exceedingly rare, and anesthetic management is particularly important in such cases because the attending anesthesiologist and surgeon must consider the effects of the anesthesia, the patient's position, and surgery on the fetus. We administered an epidural anesthesia for percutaneous endoscopic lumbar discectomy at 35 weeks of gestation with the patient in the prone position. The patient maintained an uneventful pregnancy and delivered a healthy baby at 38 weeks of gestation

The purpose of this study was to explore the parenting experiences of mothers of disabled children. The study focused on how mothers of disabled children prepared for their children's transition to elementary school and how they experienced their children's adjustment to school. Twenty mothers of children with developmental or intellectual disabilities participated in the study. Each mother had experienced an inclusive education program at an elementary school for more than a year. Twelve mothers have children with intellectual disabilities and eight have children with developmental disabilities. Individual in-depth interviews were carried out to collect qualitative data. To analyze the data, the research followed the phenomenological analysis method of Giorgi. The results showed that mothers of disabled children were actively involved with inclusive day care centers and therapy programs to prepare for children elementary school. Most wished to send their children to a general elementary school with an inclusive program, although decision making was not easy. When their children entered elementary school, some mothers observed their children's struggle with school and their peer relationships. They sought support from teachers and other mothers. These mothers showed a desire for their children's social independence. This study highlighted the necessity to develop support programs for disabled children and their mothers.

BackgroundThe authors evaluated the effect of intrathecal mixture of ginsenosides with neostigmine on formalin-induced nociception and made further clear the role of the spinal muscarinic (M) receptors on the activity of ginsenosides.MethodsA catheter was located in the intrathecal space of male Sprague-Dawley rats. Pain was evoked by injection of formalin solution (5%, 50 µl) to the hindpaw. Isobolographic analysis was done to characterize drug interaction between ginsenosides and neostigmine. The antagonism of ginsenosides-mediated antinociception was determined with M1 receptor antagonist (pirenzepine), M2 receptor antagonist (methoctramine), M3 receptor antagonist (4-DAMP), M4 receptor antagonist (tropicamide). The expression of muscarinic receptor subtypes was examined with RT-PCR.ResultsIntrathecal ginsenosides and neostigmine produced an antinociceptive effect during phase 1 and phase 2 in the formalin test. Isobolographic analysis revealed an additive interaction between ginsenosides and neostigmine in both phases. Intrathecal pirenzepine, methoctramine, 4-DAMP, and tropicamide reversed the antinociception of ginsenosides in both phases. M1-M4 receptors mRNA detected in spinal cord of naïve rats and the injection of formalin decreased the expression of M1 receptor mRNA, but it had no effect on the expression of other three muscarinic receptors mRNA. Intrathecal ginsenosides little affected the expression of all of muscarinic receptors mRNA in formalin-injected rats.ConclusionsIntrathecal ginsenosides additively interacted with neostigmine in the formalin test. Furthermore, M1-M4 receptors exist in the spinal cord, all of which contribute to the antinocieption of intrathecal ginsenosides.

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