Selective epidural analgesia.
Explore the source record for details and available documents.
Analgesia↗
Biomedical subjects
A D Nicholas
Publications and source records attributed to A D Nicholas.
Intradermal study of a new local anaesthetic agent aptocaine.
In a double-blind trial in 28 human volunteers, a new local anaesthetic agent, aptocaine, was compared intradermally at 1, 2 and 3% concentrations with lignocaine 2% and bupivacaine 0.5%. In a second trial in 27 subjects, 1% aptocaine was compared with mepivacaine and prilocaine, both 1, 2 and 3%. In terms of activity as determined by area of anaesthesia, and of duration of action, aptocaine was similar to mepivacaine and more active and long-lasting than lignocaine and prilocaine. By this route aptocaine also appeared longer-lasting than bupivacaine. Duration of action was unaffected by concentration. Aptocaine had marked vasoconstrictor activity, which was maximal at 1%. These local anaesthetic properties suggest that aptocaine merits clinical trials, especially in dentistry.
Adult↗
Epidural analgesia, fetal monitoring and the condition of the baby at birth with breech presentation.
Between December 1970 and March 1973, 138 patients with a singleton fetus presenting by the breech after 36 weeks of pregnancy were deemed suitable for vaginal delivery under epidural analgesia; 130 were delivered vaginally, 10 of them by breech extraction. There was one stillbirth and no neonatal deaths. Epidural analgesia for vaginal breech delivery seemed beneficial. In 65 cases it was possible to compare the umbilical vein pH with the Apgar score at one minute. In 35 patients a continuous recording of the fetal heart rate was used to predict the Apgar score at one minute and the results are discussed.
Anesthesia, Epidural↗