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Biomedical subjects

F M James

Publications and source records attributed to F M James.

49 records · Page 3Linked to original sources
PubMed1976

Maternal and fetal effects of lumbar epidural analgesia for labor and delivery in patients with gestational hypertension.

The effects of continuous lumbar epidural analgesia for labor and delivery were studied in 20 women with gestational hypertension. Maternal hemodynamics, renal function, acid-base, and blood gas findings were examined together with newborn APgar scores and umbilical vessel blood gas and acid-base values. Minimal change occurred in maternal renal function and hemodynamics. Maternal and bewborn aicd-base and blood gas findings were comparable to those of normotensive control subjects also receiving epidural analgesia. Apgar scores in both groups of subjects wer good. Continuous epidural analgesia is recommended as a useful form of therapy in the management of labor and delivery in women with gestational hypertension.

Anesthesia, Epidural↗
PubMed1976

A further study of general anaesthesia for Caesarean section.

Methoxyflurane or trichloroethylene in concentrations of 0.2% or 0.1% used in anaesthesia for Caesarean section were compared. There were no differences in the acid-base state or the clinical condition of the infant at delivery, or in the incidence of maternal complications, which could be related to the choice of volatile agent. Either volatile agent in the 0.2% concentration was associated with an overall incidence of maternal awareness and unpleasant dreams of 2.5%, compared with 4.9% when the 0.1% concentration was used. The incidence of maternal nausea and vomiting was less in the 0.2% series. There was an apparent relationship between the induction-delivery interval and (a) the degree of neonatal acidosis and (b) the Apgar-minus-colour scores at one minute ((A-C)1). The correlation between those indices of increasing foetal depression and increasing length of the uterine incision-delivery interval was highly significant. There was no systematic relationship between the one-minute score for "colour" and the umbilical artery PO2.

Acid-Base Equilibrium↗
PubMedDate not supplied

Bacteriologic aspects of epidural analgesia.

The incidence of contamination of catheters and syringes used during epidural analgesia for parturients and the effectiveness of bacterial filters were investigated. The effect of bupivacaine on bacterial viability and growth was also studied. Syringes in 5/101 cases were contaminated, while catheter tips located in the epidural space were sterile. Organisms isolated were skin commensals and probably originated on the hands of anesthetic personnel. Bupivacaine (0.25%) was bacteriocidal to S epidermidis and Corynebacterium spp at 37C but not at room temperature. These findings illustrate the efficacy of using bacterial filters during continuous epidural analgesia. New syringes should be used for each epidural injection as insurance against seeding of bacteria in the presence of a defective filter.

Anesthesia, Epidural↗
PubMedDate not supplied

A 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). High inspired maternal O2 levels were achieved with both technics. Vigorous, well-oxygenated infants with good umbilical-cord acid-base values were delivered during both GA and 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.

Acid-Base Equilibrium↗