Anesthesia and analgesia
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Anesthesia and analgesia · Jan 1977
Comparative StudyComparison of THAM and sodium bicarbonate in resuscitation of the heart after ventricular fibrillation in dogs.
Tris (hydroxymethyl) aminomethane (tromethamine or THAM) has been suggested as an effective substitute for sodium bicarbonate (NaHCO3) in the treatment of metabolic acidosis accompanying cardiac arrest. Even though several reports on its appraisal have been published, there is still no clear agreement on its therapeutic value. A double-blind study was therefore lndertaken to compare in 36 dogs the effectiveness of 0.6 M THAM, 0.3 M THAM, and NaHCO3 (0.892 mEq/ml) to correct metabolic acidosis produced during 3 minutes of cardiac fibrillation, followed by a 3-minute period of cardiac compression. ⋯ There was little difference in the effect of either of these drugs on mean aortic pressure and total peripheral vascular resistance. It is concluded that adequate ventilation and effective cardiac compression are still the chief criteria on which the final outcome of cardiac resuscitation depends. Correction of metabolic acidosis is important supportive therapy, but either THAM or NaHCO3 can be used with comparatively equivalent effect.
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The current status of obstetric anesthesia training in the United States is reviewed. The 39 anesthesia residency training programs having full time chiefs of obstetric anesthesia were surveyed regarding clinical practice, physical facilities, teaching and research. This paper reports the results and compares them to recommendations of JCAH, ACOG and ASA, concerning standards of patient care and resident teaching.
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Anesthesia and analgesia · Nov 1976
Local anesthetic agents--pharmacologic basis for use in obstetrics: a review.
Because of the minimal effects on mother and fetus, regional anesthetic technics are widely employed for labor and delivery. However, the literature describes at least 35 fetal and neonatal deaths and a frightening incidence of fetal distress associated with paracervical block for 1st-stage labor. ⋯ Bupivacaine, a relatively new, long-lasting local anesthetic, is extemely toxic when administered paracervically, but no deaths have been reported with its use for epidural anesthesia. While choice of method and agent must be individualized, continuous lumbar epidural block with bupivacaine appears as effective as and less often dangerous to the fetus than paracervical block.
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Anesthesia and analgesia · Nov 1976
Comparative StudyAdvantages of infant ventilators over adapted adult ventilators in pediatrics.
A lung simulator with variable compliance and resistance components was used to evaluate the dynamic compliance of the Bournes, Babybird, and Pediatric Emerson postoperative ventilators. With increase in airway pressure from combined changes in compliance and resistance, the internal compliance of the Bournes was lowest and the internal compliance of the Emerson was highest. ⋯ With constant lung compliance (10 ml/cm H2O) and increasing airway resistance, the Babybird had marked volume losses at higher volumes. Under all simulated conditions, internal compliance of the Emerson, although large, was relatively constant and the Bournes had the smallest internal compliance.