Acta anaesthesiologica Scandinavica
-
Acta Anaesthesiol Scand · Feb 1990
The effect on uteroplacental blood flow of epidural anaesthesia containing adrenaline for caesarean section.
The effect on uteroplacental blood flow of an epidural anaesthesia containing adrenaline for caesarean section was investigated in ten healthy women using dynamic placental scintigraphy with indium-113m and a computer-linked gamma camera. The epidural anaesthesia was performed with 18-22 ml bupivacaine 5 mg/ml with adrenaline 2.5 micrograms/ml followed by an i.v. balanced electrolyte infusion of 10 ml/kg b.w. A significant median decrease in the total maternal placental blood flow of 34% was found (P less than 0.01). There was also a significant decrease in maternal mean blood pressure of 3 mmHg (0.4 kPa) (P less than 0.05) and a significant negative correlation between the change in maternal blood pressure and the change in uteroplacental blood flow (r = -0.69, P less than 0.05).
-
Acta Anaesthesiol Scand · Feb 1990
Uteroplacental blood flow measured by placental scintigraphy during epidural anaesthesia for caesarean section.
The uteroplacental blood flow was measured before and during epidural anaesthesia for caesarean section in 11 women. The blood flow was measured with dynamic placental scintigraphy. After an i.v. injection of indium-113m chloride, the gamma radiation over the placenta was recorded with a computer-linked scintillation camera. ⋯ The anaesthesia was performed with bupivacaine plain 0.5%, 18-22 ml and a preload of a balanced electrolyte solution 10 ml/kg b.w. was given. The placental blood flow decreased in eight patients and increased in three with a median change of -21%, not being statistically significant. No correlation between maternal blood pressure and placental blood flow was found.
-
Acta Anaesthesiol Scand · Feb 1990
Randomized Controlled Trial Comparative Study Clinical TrialVisceral pain during caesarean section under spinal and epidural anaesthesia with bupivacaine.
In a randomized study, the incidence of visceral pain was evaluated in 46 patients undergoing elective caesarean section under spinal or epidural anaesthesia with 0.5% bupivacaine. If the patient experienced pain during the operation, a standard visual analogue scale ranging from 0 to 10 was used to assess the degree of pain. Visceral pain occurred in 12/23 patients in the spinal group and in 13/23 patients in the epidural group. In neither group was a correlation found between the cephalad level of analgesia or the intensity of cutaneous analgesia in the sacral region, and the presence of visceral pain.
-
Acta Anaesthesiol Scand · Feb 1990
Case ReportsPrilocaine-induced methemoglobinemia evidenced by pulse oximetry.
Methemoglobinemia was suspected in a healthy 19-year-old woman, when the pulse oximeter reading (SpO2) was 88% after a plexus brachialis block with 550 mg (35 ml, 1.5%) prilocaine. The patient was receiving 50% oxygen, and the PaO2 was 48.6 kPa (365 mmHg). After start of methylene blue treatment, with a total dose of 1 mg/kg, the SpO2 showed a gradual increase. This case report emphasises the potential advantage of arterial oxygen saturation monitoring with a pulse oximeter, but also the importance of the correct interpretation of the SpO2 reading.
-
Acta Anaesthesiol Scand · Feb 1990
A prospective study of risk factors and cardiopulmonary complications associated with anaesthesia and surgery: risk indicators of cardiopulmonary morbidity.
The aims of this study were: 1) to describe the frequency and type of cardiopulmonary complications, 2) to identify factors significantly associated with cardiovascular and pulmonary complications associated with anaesthesia and surgery, and 3) to estimate the total risk of cardiopulmonary complications for an anaesthetic when a combination of risk factors is present. Seven thousand three hundred and six anaesthetized patients undergoing gastrointestinal, urological, gynaecological, and orthopaedic surgery were included in the study; 6.3% (1:16) had one or more cardiovascular complications requiring intervention associated with anaesthesia and surgery, and 4.8% (1:21) had pulmonary complications. The total incidence of patients with one or more complications associated with anaesthesia and surgery was 9.4% (1:11). ⋯ The extent of pulmonary complications following anaesthesia and surgery was significantly correlated to patients aged greater than or equal to 70 years, preoperative chronic obstructive lung disease (COLD), major surgery, and to general anaesthesia involving muscle relaxants. Attempts to estimate the cardiopulmonary complications which may accompany anaesthesia and surgery provided important information about the anaesthetic course and outcome. With our model it seems possible to distinguish between very different levels of cardiopulmonary risk in the anaesthetic patient.