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Biomedical subjects

D Niv

Publications and source records attributed to D Niv.

51 records · Page 3Linked to original sources
PubMed1988

Mode of vaginal delivery and epidural analgesia.

A study was carried out on the mode of vaginal delivery in two large groups of parturients: one group comprised 11,264, of whom 0.1% were given epidural analgesia (1977-78) and the other, 10,650, of whom 50% delivered under epidural blockade (1982-83). When the incidence and reasons for instrumental intervention in these two groups were analyzed, it was found that the rate of instrumental delivery was only 1.3% higher (P less than 0.001) in the latter group, which was mainly due to factors not attributable to the epidural blockade. It may be concluded from this survey that epidural analgesia for labor and delivery does not cause an increase in the rate of instrumental delivery.

Anesthesia, Epidural↗
PubMed1987

Barbiturate narcosis and estrogen levels in women.

Pregnant women with high estrogen levels were more sensitive to barbiturate-induced narcosis and hypothermia than nonpregnant and postmenopausal women. Within each group, there was a negative correlation between estrogen level and decreased sensitivity to barbiturates. It appears that estrogen alters resistance to barbiturates through its effect on the activity of dopamine receptors.

Adult↗
PubMed1986

Augmentation of bupivacaine analgesia in labor by epidural morphine.

The analgesic properties and motor effect of epidural 0.25% bupivacaine (8 mL) were compared with those of epidural morphine (2 mg in 10 mL saline) followed by 8 mL of 0.25% bupivacaine. The study was performed on two groups of parturients (30 in each group) in active labor. Pain relief in the morphine-bupivacaine group lasted for a mean of 131.1 minutes (SD +/- 49.8) as opposed to the plain bupivacaine group -57 minutes (SD +/- 15.28). Satisfaction from analgesia in the morphine-bupivacaine group was higher as well. Motor involvement was not seen in either group. Perineal pain relief in the postpartum period lasted for a mean of 16 hours and 40 minutes in the morphine-bupivacaine group. It was concluded that the concomitant use of epidural morphine augmented the analgesic effect of 0.25% bupivacaine without motor effect.

Adolescent↗
PubMed1985

Anesthetic management of 646 consecutive cesarean section cases.

A retrospective analysis of 646 consecutive cesarean deliveries during a 1-year period was performed. The indications for cesarean section, techniques of anesthesia, fetal and maternal outcome, and complications were evaluated. Of 646 cesarean deliveries, 153 (23.7%) were elective and 493 (76.3%) nonelective. Regional block was the main anesthetic technique used for the elective (88.3%) and the nonelective (79.3%) operations. Maternal complications were few and reversible. In 96% of the newborns the Apgar score was greater than or equal to 7 at 5 min. These results suggest that regional block is the preferred anesthetic technique for cesarean section.

Adolescent↗
PubMed1984

Isolation and characterization of C-reactive protein from the dog.

Using calcium-dependent affinity chromatography on Sepharose-bearing, covalently-coupled pneumococcal C-polysaccharide, a protein was isolated from the serum of dogs that had undergone general anaesthesia and major surgery. This protein was confirmed as the canine analogue of C-reactive protein (CRP) in other species by virtue of its electron microscopic appearance, subunit composition and behaviour as an acute phase reactant. Dog CRP had an apparent molecular weight of approximately 100,000 and was composed of five subunits of approximately 20,000 MW each. Two of the five subunits in each molecule were glycosylated. Negatively stained preparations had the typical cyclic pentameric disc-like structure of proteins of the pentraxin family, and in some preparations had a tendency to form stacks. Serum from normal healthy dogs of various strains usually contained less than 5 mg/l of CRP but, following the stimulus of major surgery, an increase in the CRP concentration was first detected at 4 hr.

Animals↗
PubMed1984

Epidural analgesia for planned vaginal delivery following previous cesarean section.

The effect of lumbar epidural on the course of labor, delivery, and outcome was studied in 115 parturients with a previous cesarean section who were given a trial of vaginal delivery. One hundred three women were multiparous and 12 were grandmultiparous. Uterine contractions and fetal heart rate (FHR) were monitored continuously in all patients. Epidural block was performed using 8 mL of 0.35% bupivacaine without adrenaline. Supplemental doses were administered through an indwelling catheter. At the beginning of the second stage, 10 mL of 0.25% bupivacaine was added in the sitting position. Forty-eight women delivered spontaneously and 54 had an assisted second stage. Thirteen women delivered by a repeat low segmental cesarean section; dehiscence was observed in only one woman. Fetal outcome was satisfactory and similar to that of the authors' general parturient population.

Adult↗
PubMed1983

Selective effect of fentanyl on group III and IV somatosympathetic reflexes.

The effect of fentanyl on sympathetic reflexes evoked by supramaximal electrical stimulation of the radial nerve, and the subsequent reversal of its effects by naloxone, have been observed in 10 dogs anaesthetized with alpha-chloralose, paralysed with suxamethonium and artificially ventilated. During infusions of 5 micrograms kg-1 min-1 the late, long-latency, sympathetic response evoked by unmyelinated fibres was abolished at a mean dose of 27 micrograms kg-1 (SD 12.6 micrograms kg-1) after which the early, short-latency response evoked by small myelinated fibres was eliminated at a mean dose of 90.3 micrograms kg-1 (SD 54.6 micrograms kg-1) so that there was no longer any response to stimulation of the radial nerve. During a subsequent infusion of naloxone (200 micrograms min-1) the late response returned to control values at a mean dose of 0.5 mg and subsequently the early response reappeared to return to control values at a total dose of 1.6 mg. In 2 preparations phrenic nerve activity was abolished after 6.1 and 17.4 micrograms kg-1 of fentanyl and returned immediately before the late response, during the infusion of naloxone. In 2 preparations, induced tolerance occurred so that the early response could not be eliminated.

Animals↗
PubMed1983

Depression of nociceptive sympathetic reflexes by the intrathecal administration of midazolam.

The effect of the intrathecal administration of midazolam 0.5-1.0 mg in 1-2 ml of physiological saline solution, has been observed on responses evoked in renal sympathetic nerves by supramaximal electrical stimulation of radial and tibial nerves. In artificially ventilated dogs anaesthetized with alpha-chloralose, the intrathecal administration of midazolam caused a marked depression of reflexes evoked from the tibial nerve but had no effect on either spontaneous sympathetic activity or reflexes evoked by radial nerve stimulation. Neither the small amount (1-2 microliters) of benzyl alcohol, present as a preservative (administered intrathecally), nor midazolam 1 mg kg-1 i.v. caused any significant depression of the evoked somato--sympathetic reflexes. The effects of intrathecal midazolam were reversed by the benzodiazepine antagonists Ro 15-1788 1 mg kg-1 i.v. and Ro 15-3505 1-2 mg kg-1 i.v. but not by naloxone 2 mg i.v. It is suggested that the antinociceptive effect of locally applied midazolam could be the result of a non-opioid GABA-mediated system which may have implications in the management of pain.

Animals↗
PubMed1983

Variations in the effect of epidural morphine in gynecological and obstetric patients.

A prospective study was performed on the effect of epidural morphine (2 mg in 10 ml of saline) in three groups of patients: (1) following gynecological operations, 60; (2) following cesarean section, 120; (3) patients in active labor, 30. Pain relief in the first group was uniformly and almost invariably complete for up to 24 hours. In the second group spasmodic visceral pain was felt after about 10 hours, relieved by light analgesics. The wound was not painful. In the third group only hypoalgesia was obtained during labor, but if an episiotomy was done, the pain in the perineum was relieved. Few side effects were observed: urinary retention, vomiting, and non-segmental itching. Neither motor nor sympathetic block were noted. The somatic effect of epidural morphine was reliable and uniform, whereas visceral pain was poorly affected. The side effects cause relatively little disturbance at the dose used.

Adult↗
PubMedDate not supplied

The effect of amniotic fluid on intraperitoneal adhesion formation--an experimental study.

In an attempt to investigate the relative paucity of intraperitoneal adhesions after cesarean sections, we tested the effect of amniotic fluid on adhesion formation in rat model. Trauma was induced to the uterine serosa in 40 rats. Amniotic fluid was intraperitoneally instilled in 20 rats and saline in another 20 rats acting as controls. No inhibitory effect of the amniotic fluid could be demonstrated. The effect of the amniotic fluid and the saline solutions on fibroblastic proliferation was examined in vitro using fibroblastic cell cultures. No direct effect on fibroblast proliferation was found. It is concluded that it is not the direct effect of the spilled amniotic fluid that inhibits adhesion formation after the performance of cesarean sections.

Amniotic Fluid↗
PubMedDate not supplied

Cervical cerclage--its role in the pregnant anomalous uterus.

Twenty-nine cases of cervical incompetence were found among 98 women diagnosed as having a congenital uterine anomaly on hysterosalpingography, a high incidence of 30%. The highest incidence was found in the bicornuate uterus group--38%. The incidence of premature delivery and late abortion was higher in this group than in the rest of the patients with uterine anomalies (55% and 68%, vs. 45% and 32%). An obvious improvement in obstetrical performance was noted after cerclage. In the cervical incompetence group, term deliveries increased from 26% to 63%. Premature deliveries and late abortions dropped from 74% to 37%. Even in the patients with anomalous uterus without proven diagnosis of cervical incompetence, term deliveries increased from 64% to 96%, and pregnancies terminating prematurely dropped from 35.6% to 4%, following cerclage. No doubt exists as to the need for cerclage in cases of cervical incompetence. We also believe it should be performed prophylactically in cases of bicornuate uterus. The concept of routine prophylactic cerclage in all cases of uterine anomalies should be considered.

Abortion, Spontaneous↗