Anaesthesia
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Biography Historical Article
Stanislav Klikovich (1853-1910). Pioneer of nitrous oxide and oxygen analgesia.
The career and work of Stanislav Klikovich (1853-1910) has been reviewed. He was born in Russian occupied Poland and was a pioneer of the use of analgesic concentrations of nitrous oxide in oxygen for many painful conditions including childbirth. He based his clinical work on sound research and animal and human experimentation and recognised that the analgesic state was distinct from anaesthesia.
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Fifty healthy mothers, with normal placental function, were anaesthetised with ketamine for Caesarean section. Anaesthesia was maintained with nitrous oxide, oxygen, muscle relaxants and controlled ventilation. Surgery was conducted in the lateral tilt position. ⋯ Unpleasant dreams were reported in 5 instances. In this study ketamine appeared to be unassociated with significant biochemical asphyxia, but may have been responsible for some element of drug induced neonatal depression. In view of our own experience and that of other workers, it is suggested that ketamine induction for Caesarean section should be re-evaluated using a lower dose of the drug.
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A case is reported in which obstetric management resulted in 52 minutes elapsing between the induction of anaesthesia and delivery by Caesarean section. The mother was induced and maintained on Althesin and minimal methoxyflurane throughout this period without detriment to the neonate.