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PubMed · 435346

Cyclopropane and Caesarean section.

M B Kristoffersen
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Abstract

In a prospective study 589 patients were anaesthetized by the inhalation of cyclopropane 40% for 2--3 min. Relaxation was provided with suxamethonium and anaesthesia was maintained with cyclopropane 7.5%. The series was divided into four groups: patients in optimal condition (96 elective (group 1), 164 emergency (group 3)) and those not in optimal condition (75 elective (group 2), 254 emergency (group 4)). All infants from groups 1 and 3 had high Apgar scores, and all survived. Infants in groups 2 and 4 had lower Apgar scores, eight and 96 respectively were depressed, and 10 and 20 died because of obstetric and neonatal factors unrelated to the anaesthesia. Respiratory distress syndrome (RDS) developed in 44 infants. Among 29 infants in whom the birth weight was less than 2.5 kg the mortality was 31%, whereas no death occurred in mature infants. RDS was significantly more frequent after elective than after emergency surgery. Neonatal depression was independent of the length of the induction-delivery interval, which averaged 13.3 min. The frequency of awareness was 1.5%.

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Anesthesia, InhalationAnesthesia, ObstetricalAwarenessCesarean SectionCyclopropanesFemaleHumansInfant MortalityInfant, NewbornPregnancyProspective StudiesRespiratory Distress Syndrome, NewbornRespiratory InsufficiencyTime FactorsJournal Article

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BibTeXRIS

M B Kristoffersen. 1979. Cyclopropane and Caesarean section.. https://doi.org/10.1093/bja%2F51.3.227

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The effects of isoflurane, sevoflurane, and desflurane anesthesia on neurocognitive outcome after cardiac surgery: a pilot study.

BACKGROUND: Inhalation anesthetics such as isoflurane, sevoflurane, and desflurane are widely used in clinical practice; however, there is no study for comparing these drugs in cardiac surgery with respect to postoperative cognitive outcome and S100 beta protein (S100 BP) levels. In this study, we evaluated the effect of sevoflurane, isoflurane, and desflurane anesthesia on neuropsychological outcome and S100 BP levels in patients undergoing coronary artery bypass grafting (CABG) surgery with cardiopulmonary bypass (CPB). MATERIALS AND METHODS: Forty-two male patients were prospectively randomized and classified into 3 groups according to the volatile agents used; isoflurane, sevoflurane, desflurane. All patients had a sufficient education level to participate in neuropsychological testing and a normal carotid Doppler ultrasonography. Blood samples for analysis of S100 BP were collected before anesthesia (T1), before heparinization (T2), 15 minutes into CPB (T3), following protamine administration (T4), postoperatively (T5), 24 hours after the operation (T6), postoperative day 3 (T7), and postoperative day 6 (T8). The neuropsychological tests, including Mini-Mental State Examination (MMSET) and visual-aural digit span test (VADST), were administered 1 day prior to surgery and on the third and sixth postoperative days. RESULTS: The postoperative third and sixth day MMSET scores and third day visual-written subtest scores in the sevoflurane group were significantly lower than in the isoflurane and desflurane groups (P < .05). S100 BP levels increased with the beginning of anesthesia in the sevoflurane and desflurane groups. Although S100 BP decreased to baseline levels on postoperative day 1 in the sevoflurane group, this was significantly higher on the third and sixth days postoperatively in the desflurane group (P < .05). In the isoflurane group, the S100 BP level was significantly higher than the baseline level only after CPB (P < .05). CONCLUSION: Our study suggests that isoflurane is associated with better neurocognitive functions than desflurane or sevoflurane after on-pump CABG. Sevoflurane seems to be associated with the worst cognitive outcome as assessed by neuropsychologic tests, and prolonged brain injury as detected by high S100 BP levels was seen with desflurane.

Anesthesia, Inhalation↗