Anesthesia and analgesia
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Anesthesia and analgesia · Nov 1983
Intracranial and hemodynamic changes after succinylcholine administration in cats.
Bolus injections of succinylcholine (1.5 mg/kg) significantly increased intracranial pressure (ICP) in cats under normal conditions from control levels of 8 +/- 1 mm Hg to 16 +/- 3 mm Hg (+/- SEM, P less than 0.01), and in the presence of artificially increased ICP from control levels of 27 +/- 1 mm Hg to 47 +/- 4 mm Hg (P less than 0.01). These approximately 100% increases in ICP were accompanied by a transitory decrease in mean arterial pressure (approximately 10 sec), followed by a 15-20% increase (P less than 0.05). Pulmonary arterial pressure increased 20-30% (P less than 0.05). These results, when considered in conjunction with results previously obtained in humans, suggest that succinylcholine may be contraindicated in neurosurgical patients.
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Anesthesia and analgesia · Oct 1983
Clinical Trial Controlled Clinical TrialEpidural bupivacaine, chloroprocaine, or lidocaine for cesarean section--maternal and neonatal effects.
The effects of epidural anesthesia on maternal blood pressure, newborn Apgar scores, neonatal acid-base status, and the early neonatal neurobehavioral scale (ENNS) were studied in 54 pregnant women undergoing cesarean section. Maternal and neonatal blood levels of the local anesthetics were also determined. Group 1 (n = 16) received 0.75% bupivacaine, group 2 (n = 18) received 3% chloroprocaine, group 3 (n = 11) received 2% lidocaine, and group 4 (n = 9) received 2% lidocaine with 1:200,000 epinephrine. ⋯ At delivery, the fetal/maternal concentration ratio of bupivacaine was 0.27, that of lidocaine without epinephrine 0.48, and that of lidocaine with epinephrine 0.58. Chloroprocaine was detected in 12 maternal samples, in seven umbilical venous samples, and in six umbilical arterial samples. It is concluded that epidural anesthesia as administered in this study had no adverse effect on the newborn Apgar scores, cord acid-base status, or the ENNS.
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Anesthesia and analgesia · Oct 1983
Succinylcholine-vecuronium (Org NC 45) sequence for cesarean section.
Vecuronium (Org NC 45) was used in 27 parturients undergoing elective cesarean section under general anesthesia. One of the parturients had a twin pregnancy. Neuromuscular transmission was assessed clinically by stimulating the ulnar nerve and observing the contraction of the fingers. ⋯ Nine infants were delivered before the injection of vecuronium; 19 infants were delivered after its injection. There was no significant difference between the Apgar scores in the two groups, suggesting that vecuronium does not cross the placenta in concentrations that affect the newborn. Vecuronium may be advantageous in parturients undergoing cesarean section under general anesthesia because it maintains cardiovascular stability, is noncumulative, is readily antagonized by neostigmine, has no effect on the plasma cholinesterase activity, and has no deleterious effect on the newborn.