Acta anaesthesiologica Scandinavica
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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.
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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.