Acta anaesthesiologica Scandinavica
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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
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
Oxygen transport and venous admixture in the extremely obese. Influence of anaesthesia and artificial ventilation with and without positive end-expiratory pressure.
Eight extremely obese patients (mean weight 136 kg) were studied when awake and breathing air, and during anaesthesia with controlled ventilation (oxygen fraction in inspirate (FIO2): 0.5). During anaesthesia, the atients were first studied with zero end-expiratory pressure (ZEEP) ventilation. Then two different positive end-expiratory pressures (PEEP) were applied, 10 cmH2O and 15 cmH2O, in order to study the effect of an increase in functional residual capacity (FRC). ⋯ This was due to simultaneous reduction in QS/QT and QT. At a PEEP of 15cmH2O, the P(A-a)O2 was 21.2 +/- 7.1 kPa, oxygen availability 862 +/- 170 ml/min, QS/QT 13 +/- 4 and QT 4.4 +/- 0.6 1. It is concluded that PEEP ventilation significantly reduces QS/QT in extremely obese patients during anaesthesia and should be used in these patients if there is arterial hypoxemia despite a high FIO2.
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Acta Anaesthesiol Scand · Jan 1976
ReviewThe effect of respiratory frequency on pulmonary function during artificial ventilation. A review.
This is a review of previous studies on the effects of variations between 12 and 24 breaths per minute in ventilation frequency during artificial ventilation, minute ventilation being constant. The total material consisted of 66 healthy subjects investigated under anaesthesia with artificial ventilation and 43 patients investigated during prolonged respiratory treatment. An increase in ventilation frequency resulted in an increased ratio of dead space to tidal volume (VD/VT) and in diminished alveolar ventilation with a subsequent elevation of Paco2. ⋯ Cardiac output was increased, as was venous admixture. Pao2 was slightly reduced. The more efficient gas exchange occurring at a low ventilation frequency makes this setting preferable in the treatment of patients with chronic obstructive lung disease, whereas a high ventilation frequency, by improving cardiac output, may be advantageous in patients with circulatory failure.
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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.