Anesthesia and analgesia
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Anesthesia and analgesia · Mar 1989
Aging: effects on minimum alveolar concentration (MAC) for halothane in Fischer-344 rats.
It is well-established that the anesthetic requirement (MAC) of volatile agents such as halothane is reduced in elderly patients. The current project was designed to determine whether a similar alteration in anesthetic requirement occurs in Fischer-344 (F-344) rats, an animal model often utilized in physiology and pharmacology to examine aging-related changes. ⋯ MAC was reduced approximately 17% in aged (25 months) versus young adult (5 months) animals. From these data, it is concluded that the F-344 rat may be an adequate model for examination of age-dependent alterations in the actions of volatile anesthetics.
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Anesthesia and analgesia · Mar 1989
Randomized Controlled Trial Clinical TrialEpidural hydromorphone with and without epinephrine for post-operative analgesia after cesarean delivery.
The efficacy of epidural hydromorphone alone or in combination with epinephrine for postoperative analgesia was evaluated in 30 healthy women who underwent cesarean delivery with epidural anesthesia. They were assigned randomly to receive either 1.5 mg hydromorphone alone (N = 15) or 1.5 mg hydromorphone with 1/200,000 epinephrine (N = 15). Duration of analgesia (mean +/- SD) was 24.3 +/- 9.4 hours after the epidural injection of hydromorphone plus epinephrine. ⋯ Side effects including pruritus (73%), nausea (20%), and vomiting (15%) were of similar frequency with and without epinephrine. Although mean venous PCO2 (PvCO2) levels three and six hours after the hydromorphone-epinephrine dose were elevated significantly over the pre-drug PvCO2 levels, no respiratory depression was detected by an apnea monitor to which all patients were connected. The addition of epinephrine to epidural hydromorphone hastened onset and prolonged the duration of analgesia after cesarean section.
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The effects of general and regional anesthesia on neonates after cesarean section have been studied mainly on elective cases. In this paper we studied infants delivered by elective and nonelective cesarean section at the Winnipeg Women's Hospital from 1975 to 1983 (n = 3940) to determine the effect of anesthetic technique on neonatal outcomes. A trained anesthesia nurse interviewed all parturients and reviewed their antepartum, labor and delivery, and anesthesia records. ⋯ Among neonates delivered after elective section, general anesthesia was associated with a higher incidence of low Apgar scores at 1 minute. In neonates delivered by nonelective section, general anesthesia was associated with higher rates of low Apgar scores at 1 and 5 minutes as well as greater requirements for intubation and artificial ventilation. There were no differences seen in neonatal death rates with general and regional anesthesia in the three groups.(ABSTRACT TRUNCATED AT 250 WORDS)
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Anesthesia and analgesia · Mar 1989
Historical ArticleSixty-six years ago in Anesthesia & Analgesia. Brown, W.C.: Preliminary report on experiments with ethylene as a general anesthetic, p. 117. Luckhardt, A.B.: Carter, J.B.: Ethylene as a gas anesthetic, p. 221. Herb, I.C.: Ethylene: Notes taken from the clinical record, p. 230. Current Researches in Anesthesia and Analgesia: 1923; Vol. 2.
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Anesthesia and analgesia · Mar 1989
Comparative Study Clinical Trial Controlled Clinical TrialSurgical repair of hip fractures using continuous spinal anesthesia: comparison of hypobaric solutions of tetracaine and bupivacaine.
The aim of this study was to compare hypobaric solutions of tetracaine and bupivacaine in 30 geriatric patients undergoing surgical repair of hip fractures while under continuous spinal anesthesia. Tetracaine 1% and bupivacaine 0.5% were mixed with distilled water to prepare hypobaric 0.25% solutions. In a double-blind fashion, all patients received 3 ml (7.5 mg) of either solution in the lateral decubitus position with the operated side up, the table being kept horizontal for 30 minutes after injection. ⋯ In both groups, motor blockade was satisfactory in 29/30 patients on the operated side. The frequency of a decrease in systolic blood pressure of more than 30% was similar in the two groups. The authors conclude that hypobaric solutions of both tetracaine and bupivacaine are suitable for surgical repair of hip fractures in geriatric patients and produce comparable anesthetic and hemodynamic effects.