Articles: anesthetics.
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Ann Fr Anesth Reanim · Jan 1985
Review[Reassessment of the respective risks of anaphylaxis and histamine liberation with anesthetic substances].
A search of the French and English language literature of the last 20 years (1964-1984) yielded 975 cases of immediate anaphylactoid reactions due to anaesthetic drugs given parenterally. The accident mechanism was confirmed in only half the patients, and nearly always at a later date. The immunoallergological tests most often used in the diagnostic process were skin tests and Prausnitz-Küstner tests. ⋯ The signs most often described were cutaneous, cardiovascular, respiratory and occasionally gastro-intestinal. Whilst hypnotic drugs were responsible for cutaneous signs, muscle relaxants gave cardiovascular signs. A past history of drug allergy was found in 37% of cases, and atopy in 38%; virtually all patients had already had one or more anaesthetics.
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Obstet Gynecol Surv · Mar 1984
ReviewGeneral anesthesia in cesarean section: effect on mother and neonate.
Advances in anesthetic techniques during the past several decades have resulted in an excellent outcome in infants delivered by cesarean section under general anesthesia. To understand these results, it is important to be familiar with the physiologic changes which occur during general anesthesia. A review of the literature which focuses on the findings which led to current anesthetic principles is presented.
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Local anesthetics are in general not suitable for the treatment of patients with severe cancer pain. Local blocks are useful for diagnostic and prognostic purposes. ⋯ The use of local anesthetics may yield long-lasting relief in some specific pain syndromes, such as tumor-related reflex dystrophies, in painful muscle spasms, and trigger points due to tumor-affected vertebrae. In addition, local anesthetics may have a generally beneficial effect in the restless, cachectic, and aged patient.
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Biol Res Pregnancy Perinatol · Jan 1984
ReviewObstetric analgesia: pharmacokinetics and its relation to neonatal behavioral and adaptive functions.
The neonatal pharmacokinetic and neurobehavioral properties of certain agents used in obstetric analgesia are reviewed (local anesthetics, opiates, inhalation agents, benzodiazepines). Fetal and neonatal pharmacokinetic alterations partly explain the neurobehavioral differences observed between different drug groups and ways of drug administration. The most effective and safest method with fewest neonatal neurobehavioral effects appears to be regional epidural analgesia performed with plain bupivacaine. ⋯ Inhalation agents and parenteral pethidine (meperidine) are still clinically useful alternative compounds in circumstances where epidural analgesia is not possible. Pharmacokinetically and according to neurobehavioral assessments, inhalation agents appear to be more attractive than pethidine. Benzodiazepines, especially after high or repeated doses, may cause the so-called floppy-infant syndrome, at least partly, due to a slow neonatal drug elimination.
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This review includes a brief discussion of the indications and pitfalls of regional anaesthetic techniques commonly used during parturition. Emphasis is given to the physiological changes of pregnancy and the potential effects on the fetus. The criteria for the choice of local anaesthetic are also presented.