Acta anaesthesiologica Scandinavica
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Acta Anaesthesiol Scand · Jan 1977
General anaesthesia or lumbar epidural block for caesarean section? Effects on the foetal heart rate.
Caesarean section was performed in 10 patients under general anaesthesia and in 10 other patients under epidural block. The foetal heart rate was monitored continuously during anaesthesia and operation with a scalp electrode and a cardiotocograph. There was no major difference between the two anaesthetic techniques in their effect on the foetal heart rate. ⋯ The operative time was longer in the epidural group than in the general anaesthesia group, due to a higher frequency of Pfannenstiel incisions and repeat caesarean sections in the epidural group. Clinically, all newborns seemed to be unaffected, with normal Apgar scores. Epidural block seems to be a good alternative to general anaesthesia for caesarean section, particularly when a long operative time is expected.
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Acta Anaesthesiol Scand · Jan 1977
Comparative StudyHuman hepatic blood flow and its relation to systemic circulation during intravenous infusion of bupivacaine or etidocaine.
Fifteen healthy young volunteers were studied before and during an intravenous infusion of a local anaesthetic agent. Seven received bupivacaine and eight etidocaine in a dose rate of 2 mg/min over a period of 150 min. Variables of the central systemic circulation and also the hepatic blood flow were measured repeatedly. ⋯ In contrast, these three drugs had the same decreasing effect upon the splanchnic vascular resistance, which caused an almost identical increase in the estimated hepatic blood flow. The calculated vascular resistance in the systemic circulation, excluding the splanchnic, was unchanged during the infusion of etidocaine, while it decreased during the infusion of bupivacaine. Most of this discrepancy was due to the different plasma concentrations of the drugs.
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Acta Anaesthesiol Scand · Jan 1977
Arrhythmias during halothane anaesthesia II: the influence of atropine.
The effect of i.v. atropine premedication on cardiac rhythm was studied in healthy adult patients during thiopental-N2O/O2-halothane anesthesia without intubation. A higher incidnece of arrhythmias was seen in younger patients in close relation to administration of atropine, but the overall incidence during anesthesia was identical in atropine groups and the control groups. ⋯ No consistent changes in blood pressure were observed as the result of arrhythmias or changes in heart rate. It is concluded that atropine should be reserved for situations where severe bradycardia and hypotension occur, or can be expected to occur, and not given automatically, since cardioacceleration which is inherent in its action may be injurious to patients with limited cardiac reserve.
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Acta Anaesthesiol Scand · Jan 1977
Comparative Study Clinical Trial Controlled Clinical TrialKetamine and diazepam as anaesthesia for forceps delivery. A comparative study.
In a clinically controlled trial in forceps delivery, a comparison was made between the general anaesthesia induced by ketamine and that by a combination of diazepam and N2O. Local anaesthesia was added in the diazepam group for episiotomy and suturation. The indication for operative delivery was in all cases a prolonged second stage of labour. ⋯ One mother in each group required ventilation with oxygen due to respiratory depression of short duration. Three of the children in the ketamine group and two in the diazepam group had subnormal Apgar score with slight acidosis. This was probably not attributable to the anaesthesia.
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Acta Anaesthesiol Scand · Jan 1977
Peripheral nerve injury due to injection needles used for regional anesthesia. An experimental study of the acute effects of needle point trauma.
Nerve injury can arise as a complication peripheral nerve block anesthesia. Of the various factors involved, the trauma caused by the injection needle may be of significance. ⋯ Fascicular injury was indicated by a fluorescence microscopy technique, tracing locally applied Evans Blue Albumin, The results show that a 45 degrees-beveled needle less frequently produces fascicular damage and should therefore be recommended for use in clinical anesthesia. It is also concluded that paresthesiae, when necessary, should be elicited gently, and that intraneural injections should be avoided.