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At least 793 records · Page 44Linked to original sources
PubMed1984

[Comparative studies on general anesthesia versus peridural anesthesia in primary cesarean section].

In a prospective interdisciplinary study involving the departments of gynaecology, anaesthetics and paediatrics, the influence on both the mother and neonate of general as opposed to epidural anaesthesia was compared in 47 planned caesarean sections. Neither maternal or foetal risk factors were present in these cases, and the cardiotocogram was always normal before the anaesthetic was applied. Methods. Systolic and diastolic blood pressure were carefully monitored. Under an identical infusion regime the following parameters were estimated in maternal blood: blood gas and acid-base status, blood sugar, lactate, beta-hydroxybutyric acid, ACTH and cortisol. These same parameters were also estimated in cord blood taken at delivery. The Apgar score at 1, 5 and 10 minutes, and a complete paediatric assessment including neurostatus at 15 minutes, 24 hours and 7 days of age were used to assess neonatal status. Some of the women given a general anaesthetic initially had marked increases in blood pressure and pulse, while about a third of the epidural cases showed a blood pressure fall despite positioning in the left lateral position in order to prevent the aorto-caval syndrome. An increase in lactate, ACTH and cortisol was found in both groups up to the time of delivery, when the ACTH level of the general anaesthetic group was significantly higher. Acid-base and PCO2 values were not markedly influenced by either of the techniques used, but the maternal capillary PO2 levels were very much higher in the general anaesthetic group. The neonates born under general anaesthetic had a lower 1 min Apgar score, as a result of the relatively long induction-delivery time, of on average 17 min. The 5 and 10 min Apgar scores and the neurophysiological development of the babies revealed no differences between the two groups.

Adult↗
PubMed1984

[Differences in IgM increase following operations in general anesthesia and paraspinal regional anesthesia].

The serum immunoglobin levels of 74 patients with a prosthetic hip operation were studied. 36 patients received general anaesthesia with thiopental sodium, succinylcholine, alcuronium and halothane, whereas 38 patients were given a catheter epidural anaesthesia (CEA) with bupivacaine. Both collectives were subdivided into four groups, in whom the loss of blood was substituted by either human albumin 5%, dextrane, gelatine, or hydroxyethyl starch. Patients with a general anaesthesia had a high increase in serum IgM on the 7th day after operation, whereas there was no increase in the patients who had received CEA. In all the other parameters there was no difference between the various anaesthetics; likewise, the individual volume substitution management procedures did not produce differences in these parameters. IgM elevation is interpreted as a reaction to an affection of the tracheo-bronchial system; this reaction did not occur with the CEA group. The cause of the reaction is the interaction of immunomodulating drugs, and changes in ventilation that lead to an activation of the immune system.

Anesthesia, Epidural↗
PubMed1983

[Combination of local anesthesia and intubation anesthesia in ophthalmic surgery - a gentle anesthetic technic for high risk patients].

Local analgesia has its definite place in ophthalmic surgery, but is restricted to short-term procedures. Major surgery involving longer periods of manipulation, especially of the retina and vitreous body, usually require general anaesthesia. These patients, predominantly elderly and of reduced general health, are at risk especially during the postoperative period. Regaining consciousness and protective reflexes quickly is essential in this group. To reduce the dosage of potent general anaesthetics in a pilot study a special risk group received a combination of retrobulbar local analgesia and light general anaesthesia. It was found that with optimal local blockade of pain conduction, general anaesthetics could be reduced as compared to a control group receiving general anaesthesia alone. The special advantage of this combined anaesthetic technique became evident during the postoperative period, since foreshortened recovery of consciousness, complete orientation as to time and space allowed referral to the ward at an early date. Particularly advantageous in these patients at risk was the prolongation of analgesia in the operated eye well into the postoperative period.

Adult↗