Acta anaesthesiologica Scandinavica
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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
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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Segmental epidural analgesia (T10-T12) was performed in 418 parturients, using a 4-6 ml dose of 0.5% bupivacaine, with or without adrenaline. Seventy per cent of parturients were primiparas and 30% had histories, or signs, of possible uteroplacental insufficiency. Our aim was to relieve pain during the long passive opening phase, so that mothers would be rested and active at the beginning of the second phase, but also to avoid abolishing the bearing-down reflex, the absence of which causes an increased frequency of instrumental delivery. ⋯ Slight, but rapidly correctable, hypotension occurred in 16.5%, and in two cases the hypotension led to more serious complications. This stresses the importance of the availability and competence of both the anaesthetic and obstetric teams. There were no maternal or neonatal mortalities, and the Apgar scores compared well with the figures for the normal material in our obstetric unit.
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Acta Anaesthesiol Scand · Jan 1977
Intubation of newborns and infants: a solution to the problem of water condensation.
Treatment with humidified air in intubated newborns and infants its often complicated by the embarrassing problem of water condensation. This problem is solved by the humidification system described below, in which the tube delivering humidified air is surrounded by an Armaflex-insulated spiral-wire tube. Through the space between the two tubes, an adjustable air warmer delivers dry air at a temperature and flow rate such that the temperature of the humidified air in the delivery tube is maintained above its dew-point temperature.