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
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.
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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.