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Biomedical subjects

H T Andersen

Publications and source records attributed to H T Andersen.

At least 37 records · Page 2Linked to original sources

Obstetrical analgesia assessed by free fatty acid mobilisation.

Two groups of six parturients each have been compared. One group received centrally acting analgesics, sedatives and intermittent nitrous oxide and the other group was given epidural anaesthesia. The serum free fatty acid (FFA) concentrations of the parturients in the former group increased steadily during labour, attaining peak values between 1050 and 1750 mumol/l at delivery. In parturients belonging to the epidural group, the serum FFA concentrations remained level or even fell towards the time of delivery. It is suggested that the increase in serum FFA reflects a stress induced adrenergic lipolysis which may be used to assiss the various methods for obstetrical analgesia. It is concluded that epidural anaesthesia is superior to the conventional methods of pain relief. Analyses of blood sampled from the unbilical veins show that the concentrations of FFA in the blood of the newborns do not reflect the corresponding maternal values. Thus, epidural anaesthesia does not seem to deprive the fetus of FFA during labour since the factor limiting its transfer appears to be independent of the concentration gradient over the placental membrane.

Adult↗

Epidural anaesthesia as an alternative to caesarean section in the treatment of prolonged, exhaustive labour.

Epidural anaesthesia was given to nine parturients who were considered candidates for delivery by caesarena section due to prolonged exhaustive labour. Upon pain relief and oxytocin infucion guided by cardiotocography, vaginal delivery took place. Delivery was spontaneous in seven cases, two were instrumentally delivered. It is concluded that an efficient epidural block tends to restore uterine contractility by reducing the inhibitory influences exerted by adrenergic mechanisms and unfavourable changes in the acid-base balance.

Adult↗

Continuous epidural anaesthesia with a low frequency of instrumental deliveries.

The results of 204 cases of regional analgesia by means of continuous epidural block during labour and delivery are reported. The frequency of instrummental intervention using forceps or the vacuum extractor is low, less than 15% for primi- and multi-gravidas combined, although pathological conditions were recognized prior to blockade in almost one-third of the parturients. Moreover, the frequency of emergency Caesarean section has dropped significantly since epidural anaesthesia was introduced into the clinic. The 1 min Apgar scores of babies born to mothers given epidural anaesthesia are similar to those of babies born to mothers receiving conventional analgesic agents. The amount of blood lost by mothers given epidural anaesthesia was, on average, 15% less than in a control group. It is concluded that the essential feature of our technique of administering continuous regional analgesia is a selective block of small pain fibres with the deep tactile sensations largely intact, and the motor pathways virtually unaffected. This has been achieved using small doses of bupivacaine 0.25% concentration and meticulous observation of the individual patient.

Anesthesia, Epidural↗