Acta anaesthesiologica Scandinavica
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Acta Anaesthesiol Scand · Jan 1976
Randomized Controlled Trial Clinical TrialArrhythmias during halothane anesthesia I: The influence of atropine during induction with intubation.
The changes in cardiac rhythm which occurred during induction of halothane-N2O/O2 anesthesia with thiopenthal and one single dose of suxamethonium for intubation were studied in two groups of patients, one (at random) of which was given atropine intravenously 0.1 mg/10 kg 2 min before induction.
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Acta Anaesthesiol Scand · Jan 1976
Anesthesia for cesarean section III: effects of epidural analgesia on the respiratory adaptation of the newborn in elective cesarean section.
A rise in fetal Paco2 was observed after elective cesarean section in patients anesthetized both with a barbiturate and with nitrous oxide/oxygen. Epidural analgesia seemed to be a good alternative in order to attain better blood gas values in the newborn infant. Fourteen healthy mothers and their infants were studied in connection with elective cesarean section. ⋯ Maternal blood pressure falls were observed in four cases, and fetal effects could be detected. Although epidural analgesia has a more favorable effect upon the newborn's metabolic component, both the compared methods allow good respiratory adaptation provided they are used correctly. Mothers can be given the opportunity to choose between being conscious or asleep when their child is delivered.
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Acta Anaesthesiol Scand · Jan 1976
Anesthetic management of posterior fossa surgery in the sitting position.
From the surgical aspect, the sitting position gives good surgical access to the operative site, improves venous drainage, gives a better view of facial area for monitoring evoked responses from cranial nerve stimulation and allows for better ventilation. Conversely, the sitting position can present complications such as air emboli, postural hypotension and serious cardiac arrhythmias due to surgical stimulation of cranial nerves and brainstem. This paper presents our clinical experience in 180 neurosurgical procedures on the posterior fossa in the sitting position. ⋯ Surgical stress also accounted for the 13 patients (7%) having frequent premature ventricular extrasystoles. One case of profound hypotension and another case of virtual cardiac standstill were noted during the use of the bipolar electrocautery at or near the fifth nerve exit from brainstem. Additional hemodynamic data, the physiopathology, diagnosis and treatment of air embolism is discussed.
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Acta Anaesthesiol Scand · Jan 1976
Anesthesia for cesarean section IV: placental transfer and neonatal elimination of bupivacaine following epidural analgesia for elective cesarean section.
Epidural analgesia with bupivacaine was used for elective cesarean section, and repeated maternal and neonatal blood samples were collected over 24 h for calculation of drug concentration. A gas-chromatogrphic micro-method was used for the analysis. The aim of this investigation was to evaluate the placental transfer and the elimination rate of the drug. ⋯ The fetal-maternal ratio of concentrations at delivery was higher than in previous studies, most probably due to the protein-binding characteristics of bupivacaine and the dosage used. The biological half-life of the rapid phase of elimination (alpha-phase) in the newborn was shorter than in the mother (P less than 0.002), indicating a more rapid distribution process. The half-life of the slow phase of elimination (beta-phase) in the newborn was of the same magnitude as in the mother, indicating that neonatal elimination processes of bupivacaine may be well developed at birth.
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An open reservoir for the collection and evacuation of anaesthetic gases permits leakage to room air. The use of a closed reservior for the removal of overspill gas from anaesthetic circuits is described. Calibrated gas evacuation is carried out through an ejector flowmeter from the anesthetic circuit or from a closed reservoir, where the gas is collected via a relief valve. In order to eliminate the risk of high or low pressure in the reservoir employed, a relief valve and a dumping valve is included in the system.