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Results for “epidural anaesthesia”

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At least 19 recordsLinked to original sources
PubMed1979

Redistribution of body heat during anaesthesia. A comparison of halothane, fentanyl and epidural anaesthesia.

Epidural anaesthesia and high dose fentanyl (50 micrograms/kg) when used to supplement nitrous oxide and oxygen anaesthesia for a standard lower abdominal operation were associated with a mean fall in deep body temperature, as measured in the external auditory meatus, of 0.46 degrees C and 0.6 degrees C/hr respectively. This is significantly different from the mean values of 0.14 degrees C and 0.2 degrees C/hr which were recorded when moderate dose fentanyl (10 micrograms/kg) or 0.5% halothane were used to supplement anaesthesia. When mean skin temperature is combined with the core temperature to provide an estimate for total body heat, there is no difference between the groups. Redistribution of body heat occurs and this may be related to reduced adrenergic stimulation and altered regional blood flow. Where the facilities and environments are inadequate for the maintenance of normothermia, care should be taken in the choice of anaesthetic technique. In the recovery period mean body heat gain showed a wide scatter of results but those patients receiving epidural anaesthesia were slow to rewarm despite a high incidence of shivering in this group. The implications of this are discussed.

Adult↗
PubMed1977

[Epidural anaesthesia in obstetrics (author's transl)].

Review of 1400 epidural anaesthesias during labour and delivery. The single shot method resulted in complete analgesia in 83.8% of the cases. There were 2.8% failures. With longer duration of albour 13.4% of the epidural anaesthesias had to be repeated. Epidural anaesthesia was tolerated well by the women in labour. Hypotension occurred in 21.6% of the cases and was corrected by intravenous infusion and positioning of the patient on the side. No adverse effects on the fetus were found. The duration of labour and delivery was not prolonged. The caesarean section rate was not increased by epidural anaesthesia. Because of the more difficult bearing down reflux during the second stage of labour, the incidence of vacuum extractions was increased by 1 to 3%. The incidence of forceps deliveries remained stable. There was no significant increase of abnormal vertex positions. Postpartum headaches because of decompression by loss of cerebrospinal fluid was seen in 2.2% of the cases. The headaches subsided on complete bed rest. One case of total spinal anesthesia with respiratory arrest is reported which necessitated immediate intubation. Another dangerous complication was noted in a Para 2 who suffered a complete uterine rupture below the level of the epidural anesthesia without any clinical signs and symptoms. Therefore continual internal fetal monitoring is considered to be essential in all cases with epidural anaesthesias. Previous caesarean sections or uterine operations are no contra-indications to epidural anaesthesia.

Anesthesia, Epidural↗
PubMed1979

Epidural abscess: a hazard of spinal epidural anaesthesia.

Two cases of spinal epidural abscess following prolonged epidural anaesthesia are presented. The clinical features included fever, malaise, and signs of nerve root compression; backache was not marked. Prompt surgical drainage and appropriate antibiotics are required to avoid the costly sequelae of bladder and leg paralysis from spinal cord compression. Both infections were caused by bacterial contamination of catheter, and although this complication is uncommon, it emphasizes that strict asepsis is essential during continuous epidural anaesthesia.

Abscess↗
PubMed1978

Peroperative haemorrhage and epidural anaesthesia in major abdominal surgery. A retrospective study.

The preoperative blood loss during resection of the colon, abdominal-perineal excision of the rectum and cystectomy, according to the method of Bricker, was studied from anaesthetic reports. The period under study was 18 months. A total of 97 patients were divied into two main groups according to the type of anaesthesia (general anaesthesia and general anaesthesia combined with epidural analgesia), as well as into sub-groups according to the type of operation. An evaluation was made of the blood loss, peroperative mean arterial blood pressure and the duration of the operation. In contrast to reports published earlier on other types of operation, we have been unable to demonstrate a significant reduction in the blood loss of patients given general anaesthesia plus epidural analgesia, despite a lower mean arterial blood pressure during the operation. We ignored any possible postoperative beneficial effect of epidural anaesthesia.

Abdomen↗
PubMed1979

[Plasmacortisol and parturition under epidural anaesthesia (author's transl)].

Plasma cortisol was determined by a radioimmuno assay during labour, at and after delivery in 16 primigravidas und epidural anaesthesia and was compared with 13 primigravidas, who delivered under pentazocine or pethidine and pudendal block. Cortisol levels decreased after effective epidural anaesthesia during the first stage of labor and for delivery. They increased in the control patients for delivery and was significantly higher than in the patients under epidural anaesthesia. Two and 20 hours post partum cortisol concentrations decreased in both groups. Cortisol levels in the fetuses and newborns was markedly lower than those of mothers. At delivery, the cortisol concentration of the newborns of both groups was the same. The changes of cortisol concentrations in this study support the conclusion that epidural anaesthesia during labor and delivery reduces stress for the mother, but not for the fetus.

Anesthesia, Epidural↗
PubMed1977

[The influence of abnormal vertebral column on failure in epidural anaesthesia (author's transl)].

In 387 pat., we observed the interdependence of abnormal vertebral column and failures in epidural anaesthesia by medial tap with the "los of resistance" method. We could show that in contradistinction to other opinions scoliosis induces no higher rate of failure of epidural anaesthesia than the normal vertebral column. In patients with kyphoscoliosis and ossified ligaments the epidural space was identified less frequently than in the normal group, perforations of the dura were encountered more frequently. These results are statistically significant. In patients who had or have pain in the back (p.e. lumbago) and those with ossified ligaments we found significantly more pain during operation although analgesia was tested before. In these three abnormalities of the vertebral column we recommend to judicously balance advantages against disadvantages of epidural anaesthesia and alternative anaesthetic procedures.

Anesthesia, Epidural↗
PubMed1979

[Haemodynamic alterations after epidural anaesthesia in geriatric patients (author's transl)].

In 22 elderly patients haemodynamic alterations after epidural anaesthesia with Carticain 2% (Ultracain) with epinephrine (1:200 000) were compared to those after Lidocaine 2% with epinephrine. There were no differences to be found in these agents, and a less pronounced depressing effect of Carticain on circulation could not be confirmed. Unlike young people elderly patients only develop slight and short rises of heart rate and cardiac output after epidural anaesthesia, which are not sufficient to compensate for the distinct fall of mean arterial pressure up to the 15th minute. In our study mean arterial pressure decreased to critical values which might lead to cerebral and coronary ischemia in these patients. Adequate prophylactic and therapeutic measures are discussed.

Aged↗
PubMed1978

A comparative study of carticaine and prilocaine in epidural anaesthesia.

Carticaine and prilocaine (without adrenaline) in epidural anaesthesia were compared in a double blind study. Carticaine and prilocaine were used in 2 % concentration without adrenaline. The latency time was not significantly different, but carticaine was a shorter acting local anaesthetic. The motor block in both series was similar. Carticaine is a good and reliable analgesic in short operations but in operations longer than one and a half hours catheter technique, adrenaline addition or local anaesthetics of longer duration ought to be used.

Aged↗
PubMed1978

[Prevention of severe hypotension caused by epidural anaesthesia for transurethral resection of the prostate (author's transl)].

Severe art. hypotensions are one of the most frequent complications of epidural anaesthesia. In 62 geriatric patients undergoing transurethral prostatic resection two methods of prophylaxis for hypotension were investigated: 1. 500ml HES before epidural anaesthesia and supine position until operation. 2. Lithotomy position immediately after EDA without plasma substitute. Blood pressure, heart rate and necessity for the application of vasoactive substances show that the lithotomy position immediately after EDA is the statistically better method. The problem of plasma substitutes in transurethral prostatic resection will be discussed.

Aged↗
PubMed1978

[The influence of the continuous epidural anaesthesia on uteroplacental blood flow (author's transl)].

Continuous lumbar epidural anaesthesia causes a drop in maternal blood pressure by decreasing flow resistance in the peripheral vascular bed. By infusion of 1000 ml NaCl blood pressure can be kept constant. Our work shows, that dilatation of the peripheral vessels has a positive effect in patients with reduced uteroplacental flow, as it results in an augmentation of placental flow. In women with normal placental function such an effect could not be seen. The practical use of these results is illustraded by a case report.

Anesthesia, Epidural↗
PubMed1979

Lumbar epidural anaesthesia.

An outline of the anatomy, physiology, indications, contraindications, complications and technique of lumbar epidural anaesthesia is presented.

Anesthesia, Epidural↗
PubMed1977

Maternal and neonatal effects of methoxyflurane, nitrous oxide and lumbar epidural anaesthesia for Caesarean section.

General anaesthetic techniques continue to be used for Caesarean section despite the possible increased incidence of foetal acidosis and neonatal depression. Two techniques of general anaesthesia (methoxyflurane-oxygen and nitrous oxide-oxygen) and lumbar epidural anaesthesia were compared in 37 patients under-going elective Caesarean section. Apgar scores at birth were similar in all three groups. Neurophysiological testing of the neonates at six hours and twenty-four hours of age revealed a superiority for the methoxyflurane-oxygen and lumbar epidural techniques, although the babies in the epidural group tended to be hypotonic. Cord blood gas analysis showed the babies in the methoxyflurane group to have a higher PaO2 with less metabolic acidosis than the babies from the other two groups. The maternal effects of the three anaesthetic techniques were similar, with only a small rise in serum fluroide levels noted in the methoxyflurane group.

Anesthesia, Epidural↗
PubMed1977

[Complete loss of brainstem-functions following epidural anaesthesia (author's transl)].

A 77 year old male patient developed complete loss of brainstem-functions following epidural anaesthesia for prostate electroresection. On the basis of anatomical and pathophysiological considerations an attempt is made to explain the development of this event. The most important factor seems to be that the local anaesthetic agent can diffuse into the subarachnoid space via the arachnoid villi, which can protrude into the epidural space. Once in the subarachnoid space the anaesthetic can ascend. By this mechanism a complete loss of brainstem functions may evolve. Survival without residual deficit is possible if immediate intensive care with control of the vital functions is instituted.

Aged↗
PubMedDate not supplied

[Epidural anaesthesia associated with induction of labour. A clinical study. Electronic monitoring of the physical and biological parameters (author's transl)].

73 case histories of induction of labour under epidural anaesthesia have been studied very thoroughly from the different parameters of the uterine contractions as well as the fetal heart rate and the acid base balance of the fetus. From this study it is clear that the basal tone, the intensity and the frequency of contractions and the activity of the uterus are increased in comparison with different studies of normal labour. This increase however is within physiological limits and does not change in any marked way the cardiac rhythm nor the acid base balance of the fetus. The Apgar score at birth is equal to or above 8 in 89 p. 100 of cases at 1 minute and in 100 p. 100 of cases at 5 minutes. Finally, in the last phases of the labour dilatation is quicker than in normal delivery. It follows therefore that maternal comfort has not been bought at the expense of the fetus.

Acid-Base Equilibrium↗
PubMed1978

Blockade of the Ferguson reflex by lumbar epidural anaesthesia in the parturient sheep: effects on oxytocin secretion and uterine venous prostaglandin F levels.

The role of oxytocin in the increase in utero-ovarian venous prostaglandin F (PGF) level caused by vaginal distension was investigated by using lumbar epidural anaesthesia to block the oxytocin secretion reflex. Whereas vaginal distension raised jugular venous oxytocin and utero-ovarian venous PGF levels in untreated sheep, neither response occurred after lumbar anaesthesia. Lumbar anaesthesia had no effect on the rise in utero-ovarian venous PGF level caused by administered oxytocin. These findings support the suggestion that a reflex release of oxytocin is involved in the elevation of utero-ovarian venous PGF observed after vaginal distension in parturient sheep.

Anesthesia, Epidural↗
PubMedDate not supplied

Epidural anaesthesia.

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Anesthesia, Epidural↗