Anesthesia and analgesia
-
Anesthesia and analgesia · May 1995
Comparative StudyHydroxyethyl starch versus lactated Ringer's solution in the chronic maternal-fetal sheep preparation: a pharmacodynamic and pharmacokinetic study.
Administration of fluids intravenously prior to spinal and epidural analgesia in obstetrics is required to prevent maternal hypotension and fetal hypoxia. A colloid solution, such as hydroxyethyl starch (HES), might be preferable considering the capacity to stay intravascularly for a longer period. In this study the placental transfer of HES and the hemodynamic effects after infusion were investigated using a chronic maternal-fetal sheep preparation. ⋯ In contrast, infusion of RL did not significantly change these variables. Infusion of HES increases UBF, CO, and uterine and total oxygen-carrying capacity in the pregnant ewe. No significant transplacental transfer of HES was shown.
-
Anesthesia and analgesia · May 1995
Ventilatory effects, blood gas changes, and oxygen consumption during laparoscopic hysterectomy.
We evaluated the ventilatory effects and blood gas changes of prolonged CO2-pneumoperitoneum in nor-moventilated patients and examined the respiratory and gas exchange consequences of head-down positioning (25-30 degrees) and CO2 insufflation into the peritoneal cavity in 20 patients without major cardiorespiratory disorders in various phases of laparoscopic hysterectomy. The patients received general anesthesia with isoflurane, fentanyl, and vecuronium, and minute ventilation (MV) was adjusted to maintain the PETCO2 at 33-36 mm Hg throughout the entire procedure, either by increasing the tidal volume (TV) and keeping the respiratory rate (RR) at 12/min (10 patients) or by changing the RR and maintaining the TV at 8 mL/kg (10 patients). Arterial and mixed venous blood samples were collected simultaneously for blood gas analysis and for measurements of oxygen consumption, and respiratory mechanics and gases were recorded by an anesthetic gas analyzer and side stream spirometry device. ⋯ The compliance decreased by 20% with the head-down position and by an additional 30% with the increased intraabdominal pressure. PaCO2 and mixed venous PCO2 increased with CO2 insufflation, and the arterial to end-tidal PCO2 (a-etPCO2) gradient increased by 1.5 mm Hg during laparoscopy. A mild metabolic acidosis developed.(ABSTRACT TRUNCATED AT 250 WORDS)
-
Anesthesia and analgesia · May 1995
Randomized Controlled Trial Clinical TrialThe antiemetic efficacy of prophylactic granisetron in gynecologic surgery.
Postoperative nausea and vomiting are common after recovery from anesthesia. We examined the prophylactic effect of granisetron on postoperative nausea and vomiting in 120 female patients (ASA physical status I) undergoing gynecologic surgery. They were randomly allocated to one of three groups (n = 40 for each): saline (as a control), granisetron 20 micrograms/kg, and granisetron 40 micrograms/kg. ⋯ The adverse events in the granisetron groups were similar to those in the control group. The administration of granisetron had no significant effect on vital signs or clinical laboratory test profiles. Granisetron given at 20 or 40 micrograms/kg i.v. during anesthesia appears to be a simple, effective, and safe method for preventing postoperative nausea and vomiting.