Articles: general-anesthesia.
-
The effects on the haemodynamic and biochemical parameters of three different anaesthetic induction regimes, namely fentanyl (4.1 micrograms.kg-1 or 15 micrograms.kg-1) plus 60 per cent nitrous oxide with oxygen and fentanyl 15 micrograms.kg-1 plus 60 per cent nitrogen with oxygen, were studied in patients undergoing coronary artery surgery. Fentanyl 15 micrograms.kg-1 with nitrous oxide and oxygen produced simultaneous reductions in oxygen uptake, cardiac index and left ventricular stroke work with an unaltered oxygen extraction. Diastolic blood pressure (an index of coronary artery perfusion) was only slightly reduced, and there were no changes in arterial lactate, glucose and free fatty acids. ⋯ The patients receiving fentanyl 15 micrograms.kg-1 with nitrogen and oxygen showed increases in heart rate, blood pressure, cardiac index and left ventricular stroke work, together with a significant fall in oxygen extraction. Moreover, in the patients who received fentanyl 4.1 micrograms.kg-1 with nitrous oxide and oxygen and fentanyl 15 micrograms.kg-1 with nitrogen and oxygen there were significant increases in blood lactate, glucose and free fatty acids, indicating increased sympathetic activity. We conclude that fentanyl 15 micrograms.kg-1, together with 60 per cent nitrous oxide with oxygen provides a satisfactory haemodynamic and biochemical state during induction of anaesthesia in patients with myocardial function prejudiced by coronary artery insufficiency.
-
It may be presumed that in 1979, 150 maternal deaths will occur in obstetrics (0.27 per 1000) in the Fed. Rep. of Germany, 40% of which will be due to caesarean sections. From 30% to 50% of this maternal death rate, must be related in one or another aspect to general or local anaesthesia. ⋯ Anaesthesists as well as obstetricians should be aware of the increased maternal risk from general or local anaesthesia. The maternal risk should be minimized. This can either be achieved if experienced anaesthesists only are responsible for obstetric anaesthesia (general as well as epidural, spinal etc.) if anaesthesia (general as well as local) is not considered as a comfortable service only but a strictly indicated medical procedure, and if new methods are developed to overcome the particular maternal risk in some regard.
-
Minerva anestesiologica · Apr 1980
Comparative Study[Delivery by cesarean section under general anesthesia and the neurobehavioral assessment of the newborn infant].
The problem of the effects on newborns of the anaesthetics administered to the mother has been reviewed. For research purposes Pentothal, widely used for induction in Caesarean section was considered. In spite of the presence of fair quantities of this drug, as demonstrated by foetal blood withdrawn from the umbilical cord, the newborns examined and submitted to painstaking neuro-behavioral assessment using Brazelton's method, did not show any signs of neurological impairment nor diversity in behaviour compared to a control group.
-
A retrospective examination of all maternal deaths at Queen Charlotte's Hospital in the last 20 years shows that general anaesthesia is the greatest single cause of maternal death. This highlights the need for considerable reduction in the inherently dangerous technique of general anaesthesia to patients in labour and, where possible, its replacement by extradural and spinal blocks.