Journal of clinical anesthesia
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Randomized Controlled Trial Clinical Trial
Epidural mepivacaine for cesarean section: effects of a pH-adjusted solution.
To determine the clinical effects of the alkalinization of 2% mepivacaine with epinephrine used for epidural block during cesarean section. ⋯ The alkalinization allowed the surgery to proceed more rapidly, significantly decreasing the time interval between epidural block and delivery of the infant.
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The specialty of anesthesia was established in German medicine in 1953 with the founding of the Germany Society of Anaesthesia and the inclusion of a "specialist in anesthesia" as part of the German medical training requirements. Anesthesia training is offered to students and residents and as a part of continuing education. ⋯ Of those, about 320 are fully accredited. Continuing education in West German anesthesia is very similar to that offered in the United States.
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The first ether anesthetic was administered in Germany by J. F. Heyfelder (1798-1869) at the Erlangen University Hospital on January 24, 1847. ⋯ Killian and Gauss established the first journals, Der Schmerz and Narkose und Anaesthesie, in 1928. After the Second World War, the field of anesthesia in Germany rapidly regained international standards. The journal Der Anaesthesist was founded in 1952, and the German Society for Anesthesiology and Intensive Medicine was established in 1953.
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The beginnings of organized emergency care can be traced through military history dating back to the Middle Ages. In 1769, the first civilian rescue society was established to look after shipwrecked persons. Sociological and technical requirements of the late 19th century led to the formation of different rescue associations and to writing of regulations for rescue and ambulance services. ⋯ Today the rescue service functions to bring a physician, often an anesthesiologist, to the victim as quickly as possible. Modern rescue laws fix a lead time of 5 to 15 minutes for a professional rescue service to reach the scene. The medical equipment and qualifications of personnel treating life-threatening trauma and diseases have improved, and in this context, the role of the anesthesiologist is important.
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The purpose of the study was to determine whether epidural analgesia is unsafe for trial of labor (TOL). ⋯ Uterine rupture presents as monitored fetal distress rather than abdominal pain. Thus, epidural analgesia can be used in patients attempting a TOL.