Combined spinal-extradural analgesia in the delivery room.
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Biomedical subjects
Publications and source records attributed to J Eldor.
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The effect of immersion in a jacuzzi in relieving labor pains, and on cervical dilatation was examined in 40 parturients. They were immersed in the jacuzzi during labor for an average of 25.5 minutes. Labor pains decreased during immersion by 2.59 degrees (scale of 0-10) compared with an average increase in labor pains of 0.25 degrees in 40 control women who were not immersed (p < 0.01). The cervical opening increased during immersion by an average of 1.5 cm in the test group, compared with 0.3 cm in the controls (p < 0.01). Immersion in a jacuzzi during labor is apparently associated with analgesia and accelerated cervical dilatation.
Of 684 parturients who underwent cesarean section between July 1985-August 1990, 371 (54.2%) were given epidural anesthesia; 50 (7.3%) required general anesthesia after a failed attempt at epidural anesthesia; and 5 (0.7%) underwent inadvertent spinal anesthesia because of dural penetration by the epidural needle. In 258 (37.7%) general anesthesia was decided on before operation. The intentional avoidance of spinal anesthesia for cesarean section in this university hospital is criticized.
63 nonagenarians (average age 93, range 90-97 years) were operated on between 1987-90 (twice or more in 8, total number of operations 75). 29 were done under general anesthesia, 17 epidural, 15 spinal, and 14 local. Mortality in the 6-month postoperative period was 17%; all deaths were within 35 days. Average postoperative mortality was higher among orthopedic patients (26%) than in those after general surgery (19%). 5 died after epidural anesthesia, 3 after general anesthesia, 2 after spinal anesthesia and 1 after local anesthesia.