Anesthesia and analgesia
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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
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
Dose-response relation and time course of action of pipecuronium bromide in humans anesthetized with nitrous oxide and isoflurane, halothane, or droperidol and fentanyl.
The dose-response of pipecuronium bromide, the time course of its neuromuscular blocking effects, and the reversibility of the residual block by neostigmine and edrophonium have been investigated in patients undergoing various types of anesthesia. The estimated doses of pipecuronium required for 95% depression of the twitch height were 44.6, 46.9, and 48.7 micrograms.kg-1 during anesthesia with nitrous oxide (65%) and isoflurane (group 1), halothane (group 2), or droperidol/fentanyl (group 3), respectively. ⋯ Both edrophonium chloride (0.5 mg.kg-1) and neostigmine methylsulphate (40 micrograms.kg-1) promptly reversed the residual block induced by pipecuronium. No side effects attributable to pipecuronium were seen in this study.
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Anesthesia and analgesia · Mar 1989
Comparative StudyExtent of blockade with various approaches to the lumbar plexus.
The extent of blockade when four different techniques were used for blocking the lumbar plexus was prospectively evaluated in 80 adult patients. The extent of blockade was measured by testing motor function of all nerves except the lateral and posterior femoral cutaneous nerves, which were evaluated by pinprick response. ⋯ None of the four techniques produced blockade of the sacral plexus. Perhaps our means of assessing blockade (motor) is what produced the difference between our findings and those of others.
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Intraspinal narcotics have dramatically influenced the way pain of malignant origin is managed. There has been a rapid acceptance of this modality within the anesthesia community to treat a wide variety of cancer pain problems. ⋯ Factors to be considered in patient selection should include the results of the preimplantation spinal narcotic trial, infection trial, infection and local conditions, hematologic status, physiologic and behavioral abnormalities, cost, patient support systems and life expectancy. By interfacing these factors with the unique profiles that each of the five types of implantable narcotic delivery systems offer, improved results both in terms of pain relief and patient satisfaction can be expected.