Demand analgesia and anesthesia in obstetrics: an evaluation of apparatus and technic.
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Biomedical subjects
Publications and source records attributed to L L Priano.
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This study examines perioperative urine output (UO) and hemodynamics in 24 patients who underwent radical head and neck surgery. The hypothesis tested was that "UO was not important in patients with normal renal function as long as hemodynamics were maintained." Intraoperatively, a "wet" group (13 patients) had generous amounts of intravenous (IV) fluid administered during surgery receiving 1,018 +/- 58 mL.h-1. The other "dry" group (11 patients) had fluids restricted to 426 +/- 23 mL.h-1. The intraoperative UOs for the wet and dry groups were 1.33 +/- 0.27 and 0.39 +/- 0.10 mL.kg-1 x h-1, respectively (p < 0.05). Postoperatively, the UOs for the wet and dry groups were 1.9 +/- 0.3 and 1.1 +/- 0.1 mL.kg-1 x h-1, respectively (p < 0.05). Perioperatively, there were no statistically significant differences between groups in systemic or pulmonary hemodynamics. Postoperatively, ordinary indices of renal function remained normal in both groups. We conclude that intraoperative oliguria due to moderate fluid restriction is not detrimental to renal outcome as long as systemic hemodynamics are maintained. Furthermore, not only does this relatively "dry" status not compromise hemodynamics, it affords the patient other benefits.
Four resuscitator bags were studied to see if the delivered fractional oxygen percentage (FDO2) could be affected by manually controlling the inherent reexpansion rate of the bag so as to allow a greater entrainment of oxygen rather than air into the bag. Flow rates of oxygen into the bag were varied: 5, 10, 15, and 20 liter/min. For each flow rate, bag refill (reexpansion) times were varied: 1, 2, 4 sec. The results show that such a maneuver will effectively increase the FDO2 of the bags at all flow rates tested--in certain instances to values greater than 0.8. This maneuver would be important to resuscitation situations where it is desirable to achieve better patient oxygenation.
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