摘要:

The Po2and acid‐base balance (pH, Pco2and base deficit) of the newborn, determined at the moment of birth and at 10 and 60 min after birth, were compared in two series of elective caesarean section, anaesthesia being induced with thiopentone in one series (n= 12), and with ketamine in the other (n= 16). The Po2and acid base values of umbilical cord blood at birth were correlated with the induction delivery (ID) times of the total series of patients subjected to elective caesarean section (n = 28). The ID‐times were varied between 2 and 10 min. The Po2, acid‐base values and Apgar scores did not differ between the thiopentone and ketamine groups. A significant negative correlation between the Po2of the newborn at the moment of birth and the ID‐time was found in the thiopentone group. The study suggests that ketamine is a good alternative to barbiturate as an induction agent for caesarean

ISSN:0001-5172    

DOI:10.1111/j.1399-6576.1985.tb02177.x

出版商:Blackwell Publishing Ltd    

年代:1985

数据来源: WILEY

摘要:

Haemodynamic measurements were performed on 20 healthy women before and during elective caesarean section under epidural (10 women) or general anaesthesia (10 women). The influence of the two anaesthetic techniques on the haemodynamic changes associated with operative delivery was compared. The following haemodynamic variables were studied: cardiac output (CO), stroke volume (SV) determined non‐invasively with impedance cardiography, heart rate (HR), systolic (SBP) and diastolic blood pressure (DBP), pulse pressure, mean arterial pressure (MAP) and total peripheral vascular resistance (TPR). During epidural anaesthesia, SV was largely unchanged before delivery but increased (P<0.05) following delivery. However, CO increased (P<0.05) prior to delivery due to an increase (P<0.01) in HR. A further increase (P<0.05) in CO was recorded following delivery. SBP, DBP, MAP and TPR decreased (P<0.01) during epidural anaesthesia. In the patients undergoing general anaesthesia, SV decreased (P<0.05) prior to delivery. However, CO remained largely unchanged due to an increase (P<0.01) in HR. Following delivery, CO (P<0.05) and SV (P<0.01) increased whereas HR decreased (P<0.01). SBP, DBP and MAP increased (P<0.01) prior to delivery, returning to the same level as prior to induction of anaesthesia following delivery. TPR was largely unchanged prior to delivery but decreased (P<0.01) following deliver

ISSN:0001-5172    

DOI:10.1111/j.1399-6576.1985.tb02178.x

出版商:Blackwell Publishing Ltd    

年代:1985

数据来源: WILEY

摘要:

In 120 premedicated patients undergoing general surgery, anaesthesia was induced with thiopentone 3 mg kg‐1, preceded by alfentanil 4.5, 9.0 or 13.5 μg kg‐1or fentanyl 1.5 μg kg‐1. The largest alfentanil dose attenuated the arterial blood pressure response to laryngoscopy and intubation better than the smaller doses of alfentanil. Changes in frontal muscle electromyogram or plasma cortisol and prolactin levels were not dependent on the adjuvant used. After thiopentone, 30, 7 and 17% of the patients given alfentanil 9.0 and 13.5 μg kg‐1and fentanyl 1.5 μg kg‐1, respectively, reacted to pinching of the lower abdomen. Patients given alfentanil 4.5 μg kg‐1did not tolerate the endotracheal tube after recovery from suxamethonium block and their heart rate was increased 12 min after alfentanil administration. We conclude that the antinociceptive effect of alfentanil is distinctly shorter than that of fentanyl. The analgesic potency of alfentanil is between one sixth and one ninth of

ISSN:0001-5172    

DOI:10.1111/j.1399-6576.1985.tb02179.x

出版商:Blackwell Publishing Ltd    

年代:1985

数据来源: WILEY

摘要:

Fifty boys presenting for day case circumcision were allocated randomly to receive either caudal analgesia or dorsal nerve block (DNB) to provide postoperative pain relief. Analgesia was assessed by a single, unbiased observer utilising a three‐point scale. Subsequently, parents completed a simple questionnaire. Subjects in the DNB group micturated earlier (P<0.05) and stood unaided earlier (P<0.025) than patients in the caudal group. The incidence of vomiting was significantly lower in the DNB group (P<0.05). There was no significant difference in the duration of analgesia, although that produced in the DNB group tended to wane sooner. It is concluded that DNB provides satisfactory analgesia following circumcision and has specific advantages when compared with caudal analgesi

ISSN:0001-5172    

DOI:10.1111/j.1399-6576.1985.tb02180.x

出版商:Blackwell Publishing Ltd    

年代:1985

数据来源: WILEY

摘要:

The effect of sublingual buprenorphine (Temgesic®) as a premedicant and for postoperative pain relief compared with morphine/pethidine was studied in 50 patients scheduled for elective surgery of the knee joint. Twenty‐five patients received buprenorphine 0.4 mg sublingually 1 h before surgery and the same dose on demand postoperatively. Twenty‐five patients were given morphine intramuscularly (7.5 mg or 10 mg to females and males respectively) 1 h preoperatively. This group received pethidine (75 mg) intramuscularly on demand postoperatively. All the patients were anaesthetized with halothane N2O/O2after induction with thiopentone. No significant differences were found with regard to sedation, dizziness, nausea and vomiting during the study period. Emergence shivering, confusion and restlessness just after termination of the operation were equal in the two groups. In the recovery room, however, there was a higher frequency of shivering (P0.05). It is concluded, that buprenorphine sublingually is as good as morphine intramuscularly for premedication and therefore should be recommended to patients who wish to avoid injections. For postoperative pain relief the initial dose of buprenorphine should be given intravenously. Only minor and unimportant side effects were

ISSN:0001-5172    

DOI:10.1111/j.1399-6576.1985.tb02181.x

出版商:Blackwell Publishing Ltd    

年代:1985

数据来源: WILEY

摘要:

The effect of postoperative extradurally administered morphine on lower urinary tract function was studied in female patients undergoing uterine surgery. Urodynamic measurements were made on the day before and on the day after the operation, using a DISA 2‐channel carbon dioxide (CO2) cystomictrograph. In ten patients without postoperative urinary retention no changes in cystometry were found during morphine administration, while two patients who developed acute urinary retention had a marked increase in bladder capacity and of detrusor pressure. In contrast, the urethral pressure profile was unchanged in both groups of patients. Intravenously administered naloxone tended to normalize the bladder capacity in the patients with urinary retention. These findings seem to indicate a marked effect in some patients of extradurally administered morphine and the acute urinary retention, following morphine administration, may be treated with naloxon

ISSN:0001-5172    

DOI:10.1111/j.1399-6576.1985.tb02182.x

出版商:Blackwell Publishing Ltd    

年代:1985

数据来源: WILEY

摘要:

The medical records of 303 patients undergoing fusions for scoliosis correction were retrospectively reviewed. The frequency and type of postoperative respiratory complications were compared in idiopathic versus non‐idiopathic scoliosis patients in relation to age, type of spinal fusion procedure, pulmonary function test (PFT) results and preoperative diagnoses. The following factors were found to increase the incidence of problems in the postoperative period: a non‐idiopathic type of scoliosis, mental retardation, anterior spinal fusion procedures, age of 20 or more years, a relative arterial hypoxemia and an obstructive component to the PFT's. Topics for further investigation are sugges

ISSN:0001-5172    

DOI:10.1111/j.1399-6576.1985.tb02183.x

出版商:Blackwell Publishing Ltd    

年代:1985

数据来源: WILEY

摘要:

During the period 1974–1983, 13857 subclavian or internal jugular vein catheterizations were analysed in the same hospital. The data on the catheterizations have been collected prospectively in the hospital computer. In 93% of the cases, catheterization was subclavian vein cannulation performed through the infraclavicular route. In 15% of the cases the catheter position was not ideal, verified with x‐ray; e. g. the catheter tip was turned into the internal jugular vein. Of the catheters 70% were kept in place for less than 7 days, and only 6% for over 2 weeks. More than one catheterization was required in 26% of the cases during the same hospitalization. Recatheterization is an important prophylactic measure for preventing septic complications, if suspicion of infection arises. In 5% of the cases, some complications occurred, but they were mostly minor, such as haematoma at the puncture site. More serious complications were 19 pneumothoraces (0.1%). The results suggest that subclavian vein catheterization is a fairly safe method for large‐scale use in a hospital, if only a limited group of physicians perform it. Certain precautions should, however, be

ISSN:0001-5172    

DOI:10.1111/j.1399-6576.1985.tb02184.x

出版商:Blackwell Publishing Ltd    

年代:1985

数据来源: WILEY

摘要:

Carbon dioxide tension was measured on heated skin surface (PSCO2) and in arterial blood (PaCO2) in eight adult patients during intermittent positive pressure ventilation. A total of 299 PaCO2‐ PSCO2measurements were performed at electrode temperatures of 45°C, 43°C and 38°C. The PSCO2‐PaCO2relation was evaluated using: 1) linear regression, 2) PSCO2/PaCO2ratio and 3) temperature correction methods. Both linear regression and ratio indicate temperature dependency of the PSCO2‐PaCO2relation. The temperature correction method was done with a blood PCO2temperature coefficient of 4.6% per °C and at two temperatures: electrode temperature (according to Severinghaus) and estimated capillary blood temperature. The results indicate that the relation between PaCO2, PSCO2and electrode temperature is constant enough to permit estimation of PaCO2from PSCO2during stable circulatory c

ISSN:0001-5172    

DOI:10.1111/j.1399-6576.1985.tb02185.x

出版商:Blackwell Publishing Ltd    

年代:1985

数据来源: WILEY

摘要:

Nitrous oxide exposure in a modern hospital during routine anaesthetic work was measured using a technical exposure measurement technique and compared to measurement of biologic exposure from urine samples. The study included different anaesthetic situations and also a study of the efficiency of close scavenging and general air‐conditioning in reducing nitrous oxide exposure. Exposure to nitrous oxide varied greatly. The mean nitrous oxide exposure in the total material was 53 ppm corresponding to approximately half the Swedish control limit (100 ppm) for 8 h time‐weighted avarage (TWA). The only anaesthetic situation regularly resulting in 8 h TWA exposure exceeding the control limit was paediatric anaesthesia (92 ± 67 ppm, mean ± s. d.). The use of close scavenging significantly reduced the 8 h TWA nitrous oxide exposure in paediatric anaesthesia. The reduction of exposure was not significant during other forms of anaesthesia where low levels were found when anaesthetic equipment with excess gas scavenging was used in theatres with non‐recirculating air‐conditioning. The correlation between conventional technical exposure measurement and urine headspace nitrous oxide measurement was good. Both theoretical arguments and practical experience indicate that this method can be used for assessing nitrous oxide exposure during routine anaesth

ISSN:0001-5172    

DOI:10.1111/j.1399-6576.1985.tb02186.x

出版商:Blackwell Publishing Ltd    

年代:1985

数据来源: WILEY