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Biomedical subjects

S Datta

Publications and source records attributed to S Datta.

At least 343 records · Page 19Linked to original sources
PubMed1981

Horner's syndrome during epidural anaesthesia for elective caesarean section.

Twenty ml of three per cent chloroprocaine solution was injected into the lumbar epidural space of a parturient for anaesthesia for elective caesarean section. Ten minutes after injection of the anaesthetic, the patient developed Horner's syndrome on the left side. The anaesthetic level was C7 on the affected side. Thirty minutes after the bolus dose of chloroprocaine the signs disappeared, at which time the patient received a reinforcing dose of 10 ml of chloroprocaine three per cent. The Horner's complex reappeared in eight minutes and persisted for 20 minutes. While Horner's syndrome is not uncommon in women in labour receiving lumbar epidural anaesthesia, it is virtually unknown in patients who are not in labour. The mechanism for the appearance of the syndrome in this case is unclear. The most likely explanation is that only a small amount of local anaesthetic was necessary to produce the syndrome and the subsequent bolus of anaesthetic followed pathways opened by the original dose, since a much smaller amount of anaesthetic was necessary to reproduce the syndrome.

Adult↗
PubMed1981

Epidural anesthesia for cesarean section in diabetic parturients: maternal and neonatal acid-base status and bupivacaine concentration.

Acid-base status and blood levels of bupivacaine were determined in 16 diabetic parturients and their infants after epidural anesthesia for cesarean section. The newborn infants were divided into two groups based on umbilical artery pH at birth. Group A consisted of 10 infants who had a pH of less than 7.2 and group B consisted of six infants with a pH of greater than 7.2. Neonatal acidosis was related to both the severity of maternal diabetes and the presence of maternal hypotension after epidural anesthesia. In addition, the half-life to bupivacaine was prolonged in acidotic infants. The placental transfer of bupivacaine, as judged by umbilical vein/maternal vein ratios, was significantly greater in acidotic infants.

Acid-Base Equilibrium↗
PubMed1981

Neonatal effect of prolonged anesthetic induction for cesarean section.

The relationship of induction-to-delivery and uterine incision-to-delivery intervals to neonatal outcome was studied in 105 parturient women undergoing cesarean section. Sixty patients received general anesthesia and 55 were given spinal anesthesia. During general anesthesia, induction-to-delivery intervals of more than 8 minutes and uterine incision-to-delivery intervals of more than 3 minutes were associated with significantly more instances of neonatal acidosis (umbilical artery pH 7.31 versus 7.22) and a greater incidence of low 1-min Apgar scores (4% versus 73%). In the groups receiving spinal anesthesia, prolongation of uterine incision-to-delivery interval by more than 3 minutes was found to be the only important factor influencing fetal outcome, as determined by an increased acidosis (umbilical artery pH 7.30 versus 7.18) and by depressed Apgar scores (0% versus 62%).

Acidosis↗
PubMed1981

Cerebrospinal fluid human chorionic gonadotropin levels in normal pregnancy and choriocarcinoma.

We measured human chorionic gonadotropin levels simultaneously in the serum and cerebrospinal fluid of 36 normal pregnant women and of six patients with choriocarcinoma. During normal pregnancy, human chorionic gonadotropin levels in the cerebral spinal fluid correlated well with those in the serum in both the first and third trimesters. A serum-cerebral spinal fluid human chorionic gonadotropin ratio of less than 60 has previously been reported as a sensitive diagnostic test for trophoblastic central nervous system involvement. However, we found this ratio to be less than 60 in one patient undergoing first trimester abortion and in one patient with nonmetastatic choriocarcinoma. Furthermore, two patients with documented trophoblastic cerebral metastases had serum-cerebral spinal fluid human chorionic gonadotropin ratios in excess of 60. Results of our study, thus, indicate that determination of a single serum-cerebral spinal fluid human chorionic gonadotropin ratio may not conclusively prove or exclude trophoblastic central nervous system metastases. Unless it is corroborated by other diagnostic means, a single decreased serum-cerebral spinal fluid human chorionic gonadotropin ratio is insufficient evidence to initiate multimodality treatment for presumptive central nervous system involvement.

Brain Neoplasms↗
PubMed1980

Epidural anesthesia for cesarean section: a comparison of bupivacaine, chloroprocaine, and etidocaine.

The authors studied three groups of patients undergoing elective cesarean section during lumbar epidural anesthesia with bupivacaine, 0.75 per cent (15 patients), chloroprocaine, 3 per cent (15 patients) or etidocaine, 1 per cent (ten patients). Excellent sensory and motor block were obtained with chloroprocaine and bupivacaine; sensory anesthesia was inadequate with etidocaine in most patients. Onset of anesthesia, induction--delivery interval, and stay in the recovery room were all longer with bupivacaine when compared with chloroprocaine. Fetal outcomes, as determined by Apgar scores, acid--base status and neurobehavioral testing, were equally good in all groups. At delivery, fetal/maternal concentration ratio of bupivacaine was 0.31 and that of etidocaine, 0.25. The umbilical artery--umbilical vein blood concentration difference for etidocaine was significantly higher than that for bupivacaine. Excellent clinical results were obtained using either bupivacaine, 0.75 per cent, alone, or chloroprocaine, 3 per cent- for induction and maintenance of anesthesia, supplemented with bupivacaine, 0.25 per cent, before removal of the catheter.

Acetanilides↗
PubMed1979

Effects of maternal position on epidural anesthesia for cesarean section, acid-base status, and bupivacaine concentrations at delivery.

In 25 patients excellent clinical anesthesia for elective cesarean section was obtained with lumbar epidural block using an average dose of bupivacaine of 130 mg (18 ml of 0.75 per cent solution). Supplemental drugs were not needed. All infants had normal Apgar scores at delivery. Ten patients were kept in a 35--40 degree semi-sitting supine position during induction, while 15 patients were similarly semi-sitting but turned into the left lateral position. Maternal position did not affect the adequacy of the anesthesia or the clinical condition of the infants, but did alter acid-base state and bupivacaine concentrations in the infants. At delivery, the infants whose mothers had been supine had significantly lower pH values in umbilical cord blood than those whose mothers had been in the lateral position. Also, high concentrations of bupivacaine were found in the umbilical vein blood of infants whose mothers were supine.

Acid-Base Equilibrium↗
PubMed1978

Propranolol and parturition.

Propranolol is a beta-adrenergic blocking drug with a wide spectrum of use and may diverse pharmacologic effects. This case report is an example of a parturient who was on a large dose of propranolol for idiopathic hypertrophic subaortic stenosis. The effects of this drug on pregnancy, labor, and above all, the fetus are discussed.

Adult↗