Anaesthesia
-
Randomized Controlled Trial Comparative Study Clinical Trial
Epidural analgesia in labour and maternal posture.
The effect of maternal position in the period immediately following epidural administration on analgesia and side effects was examined during labour. Patients were randomly allocated to two groups and were either turned from left to right lateral position within 5 minutes of bupivacaine administration (n = 35), or kept in the supine position, modified as appropriate, until pain relief or side effects indicated a change (n = 35). There was no significant difference between the two groups in onset or duration of analgesia, the need for supplements or in absorption of bupivacaine. ⋯ There was no significant difference between the two groups either in the frequency of hypotension (four lateral, five supine) or of fetal heart deterioration (four lateral, three supine). However motor block occurred in 15 of the lateral group and five supine (p less than 0.02). Such differences are not thought sufficient to counterbalance the potential circulatory disadvantage of the supine position.
-
Two patients are described who exhibited cardiac complications during administration of etomidate. One patient showed myocardial ischaemia and the other developed cardiac asystole.
-
Biography Historical Article
Zebulon Mennell. A pioneer of neurosurgical anaesthesia.
Dr. Zebulon Mennell, the first anaesthetist to devote himself largely to anaesthesia for neurosurgery, was born on 15 June 1876. ⋯ He was also an anaesthetist at the Royal National Hospital for Nervous Diseases, Queen Square, London, a post which he held until 1945. His writings indicate that he appreciated the problems of neurosurgical anaesthesia and he was the first individual to work in this field as a specialist.