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Biomedical subjects

G F Marx

Publications and source records attributed to G F Marx.

At least 19 recordsLinked to original sources
PubMed1992

Anaesthesia in a parturient with osteogenesis imperfecta.

A 20-yr-old primigravida at 38 weeks gestation with premature rupture of membranes and evidence of fetal distress required urgent Caesarean section. The diagnosis of osteogenesis imperfecta had been made 4 days earlier. The patient refused a regional anaesthetic. Difficulties in the administration of general anaesthesia to patients with osteogenesis imperfecta were recognized and managed accordingly. These problems are discussed and the importance of early antenatal assessment of such patients by the department of anaesthesia is emphasized.

Adult↗
PubMed1992

The introduction of nitrous oxide analgesia into obstetrics.

Nitrous oxide analgesia was introduced into obstetrics by a young Polish-Russian physician who manufactured the gas himself, mixed it with oxygen, humidified the mixture with water vapor, and devised a mouthpiece for self-administration. After assessing the results on himself, he evaluated the effects on pain relief, maternal emotion, and maternal and fetal heart rates, as well as on the frequency, duration, and strength of uterine contractions in 25 parturients. He recognized that, in contrast to chloroform, nitrous oxide did not alter uterine activity. He concluded that the advantages of nitrous oxide administration far outweighed its disadvantages.

Analgesia, Obstetrical↗
PubMed1990

Effects of epidural block with lignocaine and lignocaine-adrenaline on umbilical artery velocity wave ratios.

Umbilical artery blood velocity A/B ratios were recorded in term fetuses once before and twice after the maternal epidural injection of either 8 ml of lignocaine plain (15 women) or lignocaine with adrenaline 1:200,000 (40 micrograms) (16 women). The administration of lignocaine plain led to decreases in the ratio of varying degrees in all fetuses regardless of the height of the initial A/B ratio. The injection of lignocaine with adrenaline produced identical results in fetuses with initially normal A/B ratios. In contrast, all six fetuses with initially high A/B ratios (above 2.90) who received the adrenaline-containing anaesthetic reacted with a rise in the ratio, and two of these developed transient heart rate decelerations. Thus, if the initial resistance in umbilical blood flow is high, even the small epidural dose of 40 micrograms of adrenaline produces a further increase which may be associated with clinical implications.

Adult↗
PubMed1989

Cardiac output measurements during and after triplet gestation.

In a gravida with a triplet gestation complicated by fainting attacks and transient episodes of apparently positional hypotension, cardiac output was measured noninvasively to determine the optimal posture during cesarean section. Before delivery, cardiac output and mean arterial pressure were highest in the left semilateral position and lowest in the right semilateral posture. Shortly after delivery of the infants, cardiac output was still highest in the left semilateral position but lowest in the supine posture. Twenty-four and 48 hours later, the values were almost identical in all three positions. Noninvasive cardiac output monitoring provided a simple method of detecting the occurrence and severity of caval compression and of determining the optimal position of the gravida during cesarean section.

Adult↗
PubMed1988

Anaesthetic management of a parturient with prior myocardial infarction and coronary artery bypass graft.

An increasing number of parturients suffering from ischaemic heart disease require anaesthetic care for labour and vaginal delivery. We present the case of a 42-year-old gravida who had previously suffered a myocardial infarction and undergone coronary artery bypass grafting. Management was directed toward prevention of haemodynamic instability by alleviation of pain and stress while minimizing the risk of anaesthetic complications. Monitoring included a central venous catheter, pulse oximetry, and an automated blood pressure cuff. A judiciously administered segmental lumbar extradural block was instituted early, utilizing local anaesthetics with the narcotic fentanyl.

Adult↗