Acta anaesthesiologica Scandinavica
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Acta Anaesthesiol Scand · Feb 1985
Comparative StudyMaternal haemodynamic changes during caesarean section: a comparison of epidural and general anaesthesia.
Haemodynamic measurements were performed on 20 healthy women before and during elective caesarean section under epidural (10 women) or general anaesthesia (10 women). The influence of the two anaesthetic techniques on the haemodynamic changes associated with operative delivery was compared. The following haemodynamic variables were studied: cardiac output (CO), stroke volume (SV) determined non-invasively with impedance cardiography, heart rate (HR), systolic (SBP) and diastolic blood pressure (DBP), pulse pressure, mean arterial pressure (MAP) and total peripheral vascular resistance (TPR). ⋯ Following delivery, CO (P less than 0.05) and SV (P less than 0.01) increased whereas HR decreased (P less than 0.01). SBP, DBP and MAP increased (P less than 0.01) prior to delivery, returning to the same level as prior to induction of anaesthesia following delivery. TPR was largely unchanged prior to delivery but decreased (P less than 0.01) following delivery.
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Acta Anaesthesiol Scand · Feb 1985
Comparative StudyInfluence of two different anaesthetic agents on the newborn and the correlation between foetal oxygenation and induction-delivery time in elective caesarean section.
The PO2 and acid-base balance (pH, PCO2 and base deficit) of the newborn, determined at the moment of birth and at 10 and 60 min after birth, were compared in two series of elective caesarean section, anaesthesia being induced with thiopentone in one series (n = 12), and with ketamine in the other (n = 16). The PO2 and acid base values of umbilical cord blood at birth were correlated with the induction delivery (ID) times of the total series of patients subjected to elective caesarean section (n = 28). ⋯ A significant negative correlation between the PO2 of the newborn at the moment of birth and the ID-time was found in the thiopentone group. The study suggests that ketamine is a good alternative to barbiturate as an induction agent for caesarean section.
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Acta Anaesthesiol Scand · Jan 1985
Randomized Controlled Trial Comparative Study Clinical TrialPrecurarization with vecuronium and pancuronium in awake, healthy volunteers: the influence on neuromuscular transmission and pulmonary function.
The influence of pretreatment with pancuronium and vecuronium on the neuromuscular transmission was compared in 24 healthy, awake, non-premedicated volunteers using train-of-four (TOF) nerve stimulation and measurement of respiratory frequency, vital capacity, inspiratory force and peak expiratory flow (PEF). The subjects were randomly allocated to one of three groups. Each subject received one dose of pancuronium and one dose of vecuronium: Group I pancuronium 0.01 mg/kg and vecuronium 0.005 mg/kg; Group II pancuronium 0.01 mg/kg and vecuronium 0.01 mg/kg and Group III pancuronium 0.01 mg/kg and vecuronium 0.015 mg/kg intravenously. ⋯ In Group II one subject was unable to lift her head and had difficulty in swallowing following pancuronium 0.01 mg/kg. Only four subjects entered Group III because of an unacceptably high frequency of signs and symptoms of partial neuromuscular blockade and a decrease in median TOF ratio to 0.64 following vecuronium. The subjects felt it difficult to swallow, and one subject could just sustain head lift for 10 s following vecuronium 0.015 mg/kg.(ABSTRACT TRUNCATED AT 250 WORDS)
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Acta Anaesthesiol Scand · Jan 1985
Epidural morphine for postoperative pain: experience with 1085 patients.
A prospective study of the effect and side-effects of epidural morphine for pain relief in 1085 patients after thoracic, abdominal, urologic, or orthopaedic surgery was performed. Morphine chloride was diluted in saline or bupivacaine and administered through an epidural catheter placed at a segmental level appropriate for the type of surgery. The initial dose was 4 or 6 mg morphine and supplementary doses were given when needed to obtain complete freedom from pain during deep breathing or nursing care. ⋯ Postoperative nausea or vomiting was more frequent in women than in men (P less than 0.001). There was a higher incidence of nausea or vomiting in men experiencing pain than in men who were completely pain-free after abdominal surgery (P less than 0.001). Respiratory depression was rare and occurred as a gradually decreasing respiratory rate.(ABSTRACT TRUNCATED AT 250 WORDS)
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Acta Anaesthesiol Scand · Jan 1985
Development and evaluation of a flow-dividing unit for differential ventilation and selective PEEP.
Differential ventilation with selective positive end-expiratory pressure (PEEP) was studied in a two-compartment lung model, using one ventilator and a flow-dividing unit consisting of inspiratory flow resistors and an inspiratory threshold valve. The compliance of each lung compartment was varied between 0.15 and 0.23 1 X kPa-1 and the resistance was varied from 0 to 3.5 kPa X 1(-1) X s. The minute volume was 12 1 and the respiratory frequency 12/min, with an inspiratory:expiratory ratio of 1:2. ⋯ Large differences in the inspiratory impedance of the two lung compartments caused asynchronous gas delivery when the ventilation distribution was adjusted by means of the flow resistors. Use of the threshold valve resulted in synchronous gas delivery. The flow-dividing unit consists of non-active elements and can thus be connected to any ventilator.