摘要:

In order to assess the rate and amount of fetal uptake of lidocaine after intravenous maternal administration the authors studied 5 pregnant ewes at 118–125 days' gestation. On the basis of a technique previously developed, the animals were prepared by placement of an electromagnetic flow probe on the common umbilical artery to determine umbilical blood flow (u) and by insertion of sampling catheters in the common umbilical vein, fetal aorta, fetal bladder and maternal femoral artery. 3 days later, 7 mg/kg of lidocaine were infused over 50 minutes into the mother and blood samples were obtained as well as urine samples for a period of 5 hours for determination of levels of lidocaine and its metabolites: MEGX and GX. Additional determinations were made of blood gases, u, and protein binding of lidocaine by maternal and fetal blood. Calculations were made of fetal lidocaine uptake rate, total uptake, or accumulation at any time.

ISSN:0275-665X    

出版商:OVID    

年代:1990

数据来源: OVID

摘要:

As a result of suggestions that maternal hypotension after epidural anesthesia is more common after the use of beta-sympathomimetic agents such as ritodrine, some anesthesiologists avoid the use of regional anesthesia shortly after ritodrine administration. This concept was assessed by the authors in gravid ewes.

ISSN:0275-665X    

出版商:OVID    

年代:1990

数据来源: OVID

摘要:

Ephedrine, employed to reverse maternal hypotension during cesarean section under spinal anesthesia, can cross the placenta and affect fetal circulation and, possibly, stimulate the neonatal CNS. The current study was designed to assess such effects by means of neurobehavioral testing and assessment of spectral EEG responses.

ISSN:0275-665X    

出版商:OVID    

年代:1990

数据来源: OVID

摘要:

During the course of induction into general anesthesia of a 34-year-old for emergency cesarean section in whom difficulty in intubation was not anticipated, the passage of an endotracheal tube proved impossible despite multiple efforts with a variety of techniques. Intermittent ventilation by mask with maintenance of cricoid pressure did not prevent the deterioration of SaO2to 36% and the onset of bradycardia. The insertion of a laryngeal mask airway rapidly permitted manual ventilation to restore SaO2to 97% despite continued cricoid pressure. With the return of spontaneous ventilation, the laryngeal mask continued to be employed to administer 50:50 N2O:O2and 1% isoflurane until neonatal delivery, when midazolam-cyclizine-morphine were added. Since the period of hypoxemia of the mother was estimated to have lasted about 10 minutes, a prophylactic infusion of mannitol was given to prevent cerebral edema. The neonate did not appear unduly cyanotic at birth, with 1 and 5 minute Apgar scores of 3 and 8, and ventilation with 100% O2 rapidly corrected bradycardia of 50–60/min. The mother did well and only had a residual sore throat for 24 hours.

ISSN:0275-665X    

出版商:OVID    

年代:1990

数据来源: OVID

摘要:

In order to compare the pharmacokinetic properties of propofol in pregnant and nonpregnant females, the authors undertook to study 10 women with singleton pregnancies scheduled for elective cesarean section and 6 nonpregnant females undergoing elective laparoscopic tubal sterilization. All patients were free of significant systemic diseases or complications of pregnancy. General anesthesia for cesarean section patients was carried out with all generally recognized precautions. Anesthesia for both groups was induced with a propofol dose of 2.0 mg/kg injected over 20 seconds, neuromuscular blockade was maintained with atracurium after intubation, and anesthesia was produced with nitrous oxide-enflurane. Venous blood samples were obtained before induction and then periodically for 480 minutes after propofol injection. Samples were chromatographically analyzed for propofol concentrations and the data employed to derive pharmacokinetic parameters: distribution and elimination half-lives, apparent central volume of distribution, apparent volume of distribution at steady state, and clearance.

ISSN:0275-665X    

出版商:OVID    

年代:1990

数据来源: OVID

摘要:

Among the many techniques and drugs employed to moderate the hypertensive and tachycardie response to endotracheal intubation, recent suggestions have included the use of calcium channel antagonists. The current study was designed to assess the efficacy of diltiazem for this purpose.

ISSN:0275-665X    

出版商:OVID    

年代:1990

数据来源: OVID

摘要:

In order to determine the effectiveness of esmolol, a cardiac-selective beta blocker with a very short half-life, in controlling intubation-induced tachycardia and hypertension, 45 healthy patients were selected for a double-blind, randomized, placebo-controlled study. Following premedication with oral diazepam and administration of a non-paralyzing dose of d-tubocurarine, the patients were given the study solution IV (±acebo, 100 or 200 mg of esmolol), and then induced into anesthesia with thiopental-succinylcholine and the trachea intubated. Anesthesia was maintained with N2O-O2-isoflurane-vecuronium. Heart rate and systolic, diastolic and mean blood pressures were determined periodically from before induction until after intubation. Any adverse responses were managed by routine methods.

ISSN:0275-665X    

出版商:OVID    

年代:1990

数据来源: OVID

摘要:

Awareness during general anesthesia, especially during cesarean section, is a widely recognized problem. The following study was designed to assess two methods of detecting awareness for their clinical efficacy.

ISSN:0275-665X    

出版商:OVID    

年代:1990

数据来源: OVID

摘要:

Small doses of nondepolarizing relaxants are employed before the administration of succinylcholine to prevent or modify postoperative myalgia resulting from succinylcholine-induced fasciculation. To ascertain the effects of pregnancy on this effect, as well as to compare the efficacy of various nondepolarizing relaxants, the author studied 250 patients scheduled for first trimester termination of pregnancy under general anesthesia.

ISSN:0275-665X    

出版商:OVID    

年代:1990

数据来源: OVID

摘要:

Although statistics on mortality associated with extradural block in obstetrics are well known from Maternal Death Committees, accurate figures for morbidity are not available. To obtain such data, a joint project of the Royal College of Obstetricians and Gynaecologists and the College of Anaesthetists was undertaken. All obstetric units in the UK received a questionnaire asking for the incidence and nature of serious adverse events after extradural block for the period 1982–1986. Specific incidents requested included acute hypotension leading to cardiac arrest, acute hypotension requiring urgent and vigorous resuscitation, neurologic deficit of spinal nerves or cord lasting more than 1 month, and any other complications.

ISSN:0275-665X    

出版商:OVID    

年代:1990

数据来源: OVID