Articles: general-anesthesia.
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Anesthesia and analgesia · Mar 1977
Comparative StudyA comparison of general anesthesia and lumbar epidural analgesia for elective cesarean section.
Controversy exists concerning the choice of anesthetic technic for elective cesarean section. Several maternal and newborn parameters were compared during general anesthesia (GA) and lumbar epidural analgesia (LEA). ⋯ Umbilical artery and vein pH were better with GA, but 1-minute Apgar-minus-color scores were higher and time to sustained respiration was shorter with LEA. On the basis of this study, neither technic can be vigorously recommended over the other from the standpoint of the newborn's condition.
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The progress of understanding the special physiology and pathology of the small child, as well as the perfection of the technical equipment for pediatric anesthesia are responsible for the fact that today practically every child even during very difficult surgical interventions can be kept with security in general anesthesia. A survey of the problems occuring in pediatric anesthesia includes the following items: preoperative examination, preparation for anesthesia and surgical intervention, techniques of anesthesia, special dangers for the newborn and small children (fluid ratio, decrease of body temperature, hypoglycemia) and postoperative treatment. The author comes to the conclusion that the best conditions for general anesthesia of the small child are only present in a children's hospital where the necessary infrastructure is available. The pediatric anesthesist strongly wish therefore that also the specialists like the ophthalmologist make use of the specialised children's hospital for operative purposes.