Anaesthesia
-
A 30-year-old woman developed severe chest pain while out shopping and was admitted to the delivery suite. She was 38 weeks pregnant with her second child. ⋯ She went into spontaneous labour 30 hours later and was delivered vaginally. This report reviews myocardial infarction in pregnancy and considers the clinical management of this patient.
-
The effects of propofol on cerebrospinal fluid pressure, mean arterial pressure, cerebral perfusion pressure and heart rate were studied during induction, tracheal intubation and skin incision in 23 patients scheduled for elective craniotomy. Premedication consisted of midazolam 0.1 mg/kg intramuscularly and metoprolol 1 mg/kg orally. Measurements were made or derived at time zero and 0.5, 1, 1.5, 2 and 3 minutes after an induction dose of propofol 1.5 mg/kg. ⋯ Heart rate did not change. Propofol combined with moderate dose of fentanyl, obtunded the usual cerebrospinal fluid and arterial pressure responses to intubation and other noxious stimuli. Thus propofol seems to be a suitable intravenous anaesthetic agent for induction and maintenance in neuroanaesthesia.
-
Randomized Controlled Trial Comparative Study Clinical Trial
Cannulation of the epidural space. A comparison of 18- and 16-gauge needles.
A group of 685 obstetric patients were randomly allocated to have their epidural block performed using either a 16-gauge or an 18-gauge Tuohy needle. Bleeding was noted from needle or catheter trauma in 18% of patients and it proved impossible to insert the catheter in 3%. ⋯ Epidural analgesia, although safe, is not without hazard. It may be difficult to perform and may, rarely, cause considerable discomfort.