Zentralblatt für Gynäkologie
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Comparative Study
[Comparative evaluation of carticaine and bupivacaine in epidural anesthesia in cesarean section].
Lumbar epidural anaesthesia with Carticain (Ultracain) has been applied in 25 Caesarean Sections. The resulting data (waiting period, effective length and quality of the analgesia, blood pressure drop, postoperative phase, newborn state, side effects) have been compared with those of Bupivacain (Marcain) used for the same purpose. Carticain is fitted for purposes of obstetrical anaesthesia, even more than Bupivacain, owing to its slighter blood-pressure diminishing effect, and shorter waiting period.
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The valuation and treatment of labor pains require complete morphological and anatomical informations about the neuronal systems concerned. A review is given about modern model conceptions in perception, modulation and transmission of pain, based on the latest knowledges in the pain research. The identification of central control- and modulation systems is very important for the actual theory of pain. ⋯ Essentially, four functional stages are passed from the place of nociceptive perception to the registration in the telencephalon. These are depicted in consideration of numerous afferent and efferent, biochemical and hormonal, stimulated and inhibited modulation effects. Various pain inhibitory mechanisms, such as biogenic amines and endogenous opioids are discussed by reference to interesting aspects in new therapeutical possibilities in treatment of pain and also of labor pains.
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There are 16 ruptures of the uterus in a total of 28,391 deliveries, adequate a frequency of 0.59% or one rupture in 1774 cases. Whereas the fetal mortality is 43.7%, the maternal one amounts to 0%. Previous cesarean sections could be observed in 56.2%. The problems of ruptures of cicatrical uterus without symptoms and the complications will be referred to.