Anaesthesia
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The incidence of hypotension occurring in women undergoing Caesarean section with epidural analgesia was investigated in 60 patients receiving an intravenous preload of two litres Hartmann's solution. Hypotension occurred in only 6.7% of patients. Central venous pressure measurements in 20 patients confirmed the safety of the technique. A comparison is made with other preloading techniques.
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A method of protamine titration, with the use of the 'Haemochron 400' system for reversal of heparinisation after cardiopulmonary bypass is described. Twenty-three patients, average age 47 years, undergoing this procedure for either valve replacement or coronary artery bypass grafting were studied. Accurate reversal of heparinisation was achieved using comparatively small doses of protamine. A linear relationship between the dose ratio of protamine and heparin and the time interval between their respective administrations was defined where only a single dose of heparin had been administered.
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Comparative Study
Forum. Epidural analgesia and forceps delivery: laying a bogey.
The spontaneous and operative delivery rates on a labour ward are compared in the years before and after the initiation of an epidural analgesia service. An epidural rate of 27% of all deliveries in the first year is the only influence affecting an otherwise almost steady obstetric background. Despite this major impact, the changes in operative delivery rates are small and fail to reach statistical significance, although the decrease in spontaneous deliveries is significant. In later years the epidural rate rose to involve 72% of primiparae and 26% of multiparae, yet the pattern of deliveries tended to return toward the pre-epidural picture.