Anesthesia and analgesia
-
Anesthesia and analgesia · Jul 1978
Low-frequency positive pressure ventilation with extracorporeal carbon dioxide removal (LFPPV-ECCO2R): an experimental study.
We describe a new form of mechanical pulmonary ventilation, low-frequency positive pressure ventilation with extracorporeal CO2 removal (LEPPV-ECCO2R). In a series of animal studies the rate of mechanical ventilation was 0.66, 1, 2, and 4 min-1 at a tidal volume of 3, 10, and 15 ml kg-1. ⋯ Each experiment lasted 7 hours. Our data suggest a possible new dimension in the management of a difficult patient on mechanical pulmonary ventilation.
-
Anesthesia and analgesia · Jul 1978
Comparative Study Clinical TrialIntravenous lidocaine controls extubation laryngospasm in children.
-
Anesthesia and analgesia · Jul 1978
Comparative StudyLumbar sympathetic block with bupivacaine: analgesia for labor.
Forty primigravidas were given a bilateral paravertebral lumbar sympathetic block during stage I of labor using 10 cc of 0.5% bupivacaine and 1:200,000 epinephrine on each side. Good analgesia was obtained in 38 patients with maximal effect 7.5 +/- 3 minutes after blockage. Maternal mean blood pressure and pulse were unchanged, fetal well-being was not compromised, and labor progressed rapidly. ⋯ In comparison to continuous lumbar epidural analgesia, the procedure is technically more difficult, generally more painful, and requires a second anesthetic for delivery. It is concluded that bilateral paravertebral lumbar sympathetic block with bupivacaine provides reliable analgesia of long duration with a low incidence of undesirable side effects. However, its primary usefulness is in cases where continuous lumbar epidural analgesia is refused or contraindicated.
-
Three pregnant patients with myasthenia gravis are presented and anesthetic considerations discussed. The course of myasthenia gravis is highly variable and unpredictable during pregnancy. Anticholinesterase therapy should be maintained during labor, and the IM route of administration is preferred. ⋯ Regional anesthesia is preferred for vaginal delivery. In the case of cesarean section, general anesthesia may be preferable. Neonatal myasthenia gravis is a transient syndrome that appears in 20 to 30% of the newborns of myasthenic mothers.
-
Anesthesia and analgesia · Jul 1978
Increasing halothane concentrations reduce nitroprusside dose requirement.
There has been no description of the hemodynamic dose-response relationship between halothane and sodium nitroprusside (SNP), although these drugs are used together frequently for induction of deliberate hypotension. Utilizing aortic root cannulation and thermister-tipped pulmonary artery catheterization, this relationship was studied in 6 beagles receiving a standard 100 microgram/kg infusion of SNP solution administered at 3 different infusion rates (5, 10, and 20 microgram/kg/min) while anesthetized with 3 different concentrations of halothane (0.5, 1, and 2%). Sodium nitroprusside infusion resulted in dose-related reductions in mean arterial pressure, systemic vascular resistance, and left ventricular stroke work. ⋯ Sodium nitroprusside predictably induced hypotension during halothane anesthesia at the cost of a dose-related metabolic acidosis. Increasing the depth of halothane anesthesia afforded a greater percentage reduction in arterial pressure at each SNP infusion rate studied. Metabolic acidosis, however, developed no more rapidly at 2% halothane than it did at 0.5 or 1%.