Minerva anestesiologica
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Minerva anestesiologica · Nov 1992
[Aspiration syndrome in cesarean section. Our experience from 1980 to 1990].
In the last twenty years maternal mortality attributed to anaesthesia has decreased. Inhalation of gastric contents is the commonest cause in patients undergoing cesarean section; in fact pregnant women are considered "high risk" because of gravidic modifications. In this retrospective study of 10017 caesarean sections performed under general anaesthesia in our institution between January 1980 and December 1990, we evaluated the frequency of this syndrome (7 cases = 1:1431). ⋯ All these seven patients were admitted at our recovery room for less than 5 days; aspiration pneumonitis occurred in only three patients. Our results suggested that induction of anaesthesia with high doses of thiopental reduces complications related to light anaesthesia, including vomiting. At a dose of 5-6 mg/kg thiopental didn't produce any significant neonatal depression as documented by Apgar scores.
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The safe conduct of anesthesia and intensive care for heart transplant recipient requires a sound understanding of the pathophysiology of advanced cardiac failure through knowledge of anesthetic and cardiovascular pharmacology and an appreciation of the altered physiologic and pharmacologic responses of acutely denervated and transplanted heart. The most serious dysfunction is acute distension and failure of the transplanted heart's right ventricle. Hemodynamic monitoring and TEE are useful in the management of inotropic support during heart transplantation.