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Biomedical subjects

G Coven

Publications and source records attributed to G Coven.

11 recordsLinked to original sources
PubMed2003

Accelerated idioventricular rhythm during spinal anesthesia for cesarean section.

During cesarean section under regional anesthesia various anomalies of the electrocardiogram are reported such as bradycardia, supraventricular and ventricular premature beats, supraventricular paroxysmal tachicardia, S-T depression non-significant for myocardial ischemia and second degree atrioventricular block. We describe two cases of accelerated idioventricular rhythm in patients undergoing elective cesarean section with spinal anesthesia of which we have not found mention in the literature. This arrhythmia is not dangerous and does not usually evolve into ventricular fibrillation. During spinal anesthesia, however, it can exacerbate hypotension and, if misdiagnosed, a further administration of ephedrine can increase the duration of accelerated idioventricular rhythm. When necessary, for example in symptomatic hypotension or severe bradycardia, atropine is advised in order to inhibit vagal tone and increase the activity of the sino-atrial node, obtaining a pharmacological overdrive. This therapy is appropriate even if the frequency of the accelerated idioventricular rhythm is high.

Journal Article↗
PubMed1997

[Rationalization of the use of preoperative thoracic radiography in obstetrics and gynecology].

INTRODUCTION: Rationalizing preoperative chest radiography remains a problem in our Country. Therefore, we tried to use preoperative chest films rationally in obstetrics and gynecology to assess their impact on anesthesia planning and patient management and their use in early postoperative complications. MATERIAL AND METHODS: We examined two groups of patients: group A consisted of 570 women (mean age: 31 years) scheduled to be submitted to cesarean section but with no preoperative chest radiography; group B consisted of 471 patients (homogeneous in age to group A patients) submitted to nononcologic gynecologic surgery and with a single-projection preoperative chest radiograph. Anesthesiologic assessment, preoperative biochemical tests and EKG were performed in all patients. All patients underwent abdominal surgery under general anesthesia. The first 24 postoperative hours were monitored for possible anesthesia-related complications. The anesthesiologist need of chest radiography based on clinical findings was investigated in group A patients, as well as the importance of chest film findings in possible anesthesia-related complications. RESULTS: Group A and group B were homogeneous by mean patient age and anesthesia duration; clinical findings never suggested the need of chest radiography in group A patients. Three cardiorespiratory complications occurred (two respiratory arrests in group A and a gas embolism in group B), but the (un)availability of chest film findings made no difference in treatment. DISCUSSION: The availability of the preoperative chest radiographs of a group of healthy women of 31 years mean age does not make any difference in anesthesia planning and type. In our series, the most severe cardiorespiratory complications were homogeneous in the two groups, which confirms their random character, and the (un)availability of preoperative chest film findings made no real difference, even though the lack of radiographic evidence made patient management more demanding for anesthesiologists.

Abdomen↗
PubMed1994

[Electric cardioversion in pregnant patients with obstructive hypertrophic cardiomyopathy. A clinical case].

A case of atrial fibrillation during pregnancy in a woman at 30 weeks of gestation is described. She was affected by obstructive hypertrophic myocardiopathy, a rare disease usually non interfering with the normal course of pregnancy. The mortality rate is of 2-4% per year. The most frequent cause is "cardiac sudden death". High frequency atrial fibrillation can lead to right and left cardiac failure. The treatment of atrial fibrillation is to be chosen between a pharmacological or electrical therapy. However, during pregnancy, pharmacological cardioversion, although not excluded, could cause damaging side effects to the fetus. Conversely, according to literature, electrical cardioversion is effective on the mother and safer for the fetus. At admission the patient showed dyspnea, palpitations, tachycardia and hypotensions; ECG showed an atrial fibrillation at high frequency that required an immediate therapeutic decision. In the case we studied, we reported the recovery of cardiac rhythm with a single synchronized electric shock. Non alteration of fetal cardiac rhythm or uterine contractility was observed. Pregnancy went on without accidents until the 36th week, when a cesarean section was performed under general anaesthesia. We described our experience reviewing previous literature on the account of the rareness of the disease, its association to a pregnancy and the serious alterations of cardiac rhythm at the admission, which led us to take an immediate decision, safeguarding both the mother and the fetus.

Adult↗
PubMed1990

[Atracurium besylate versus succinylcholine during laparoscopy].

The authors report their experience with 112 female patients undergoing laparoscopy: they have been divided into two groups according to the drug used for muscle relaxation (atracurium versus succinylcholine). During the procedure the following parameters were recorded: intraabdominal pressure, arterial pressure, heart rate, arterial blood oxygen saturation, end tidal CO2 and the occurrence of adverse effects. According to the collected data they assume that atracurium can be considered the ideal muscle relaxant for this surgical procedure.

Abdomen↗
PubMed1990

[Anesthesia and the chemotaxis of neutrophilic granulocytes in newborn infants].

The authors investigated the modifications of neutrophil chemotaxis and cortisol plasma levels in the newborn delivered by cesarean section or vaginal delivery. Chemotaxis turned out to be higher in the group undergoing cesarean section, while cortisol was lower in this group. The increased activity of neutrophils can be explained with the lessened inhibitory effect of endogenous steroids and with the stimulating action of nitrous oxide.

Anesthesia, Obstetrical↗
PubMedDate not supplied

[Intravenous anesthesia during oocyte harvesting for in vitro fertilization. Description of a method].

The Authors describe their anaesthetic technique with a continuous i.v. infusion of propofol in female patients undergoing oocyte retrieval during in vitro fertilization. With this technique a great stability of the haemodynamic and respiratory parameters was recorded, adverse effects were never observed and every patient quickly regained a normal psychomotor performance. This operation can be, therefore, carried out in ambulatory regimen with complete safety and good acceptability from the patients.

Adult↗
PubMedDate not supplied

[Late hemorrhage as an unusual complication of placenta increta. A clinical case].

A 26 year old patient is urgently submitted to cesarean section for acute fetal pain. After 23 days, hysterectomy has been performed because of haemorrhagic shock. The pathology revealed a placenta increta. The lack of risk factors and the long, asymptomatic period between delivery and haemorrhage make this case noteworthy.

Adult↗