Articles: general-anesthesia.
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A patient with an intracardiac conduction defect characterised by first degree atrioventricular block due to slowed transmission through the atrioventricular node with increased refractoriness of the node, is described. Asymptomatic first degree block, rarely progressing to transient Wenckebach (type 1 second degree) block had been present for a period of 32 years until general anaesthesia was required, when profound bradycardia attributable to complete atrioventricular block developed abruptly. Subsequent investigations located delayed intracardiac conduction through the atrioventricular node, and indicated excess vagal activity rather than structural disease as the cause. The significance of first degree heart block is discussed in relation to other forms of atrioventricular conduction defect and the current recommendations for temporary pacing for elective general anaesthesia.
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Surg Gynecol Obstet · Nov 1982
The effect of general and epidural anesthesia upon neonatal Apgar scores in repeat cesarean section.
One-hundred and ninety-five elective cesarean deliveries were studied to determine the effects of general and epidural anesthesia upon the neonatal condition, as reflected by the one and five minute Apgar scores. Ninety were performed under general anesthesia, 0.5 per cent halothane, 50 per cent nitrous oxide and 50 per cent oxygen; 105 used the epidural technique, 3 per cent chloroprocaine plus 0.75 per cent bupivacaine. All patients were tilted to the left during operation. ⋯ More significantly, no correlation was noted between the duration of anesthesia and the Apgar scores in either group, p greater than 0.1. Specifically, no significant increase was found in depressed infants in the prolonged, greater than or equal to 15 minutes, incision to delivery group, p greater than 0.05. These data seem to suggest that the use of general anesthesia, in the technique described, yields infants with Apgar scores as good as those of infants delivered under regional block anesthesia and that prolonged duration of general anesthesia is not associated with a depression of the Apgar scores.
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Randomized Controlled Trial Comparative Study Clinical Trial
Alfathesin and etomidate for minor outpatient anaesthesia.
Etomidate was compared with alfathesin for induction and maintenance of anaesthesia in a double-blind fashion in 48 fit patients undergoing minor gynaecological operations as outpatients. The patients were randomized to receive either etomidate 0.3 mg . kg-1 or alfathesin 75 microliters . kg-1 as intravenous induction agents. All patients received fentanyl 1 microgram . kg-1 and breathed 70 per cent nitrous oxide in oxygen. ⋯ Recovery was equally rapid in both groups. No adverse reactions were seen. Alfathesin would appear to be preferable to etomidate as an induction and maintenance agent in unpremedicated fit outpatients undergoing minor gynaecological operations.