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Biomedical subjects

R Magno

Publications and source records attributed to R Magno.

11 recordsLinked to original sources
PubMed1979

Acid-base balance during laparoscopy. The effects of intraperitoneal insufflation of carbon dioxide and nitrous oxide on acid-base balance during controlled ventilation.

During laparoscopy the carbon dioxide used to achieve a pneumoperitoneum is absorbed from the peritoneal cavity into the blood. The object of the present study was to clarify certain aspects concerned with anesthetic and ventilatory techniques, mostly in connection with the comparison between the effects of insufflation of either carbon dioxide or nitrous oxide. Anesthesia included ventilation with a volume controlled ventilator in curarised patients. Respiratory volumes were calculated according to the patient's body area. The results show a sharp rise in PaCO2 and a fall in pH after intraperitoneal insufflation with carbon dioxide, while no changes were observed when nitrous oxide was used. The clinical consequences of these findings are discussed.

Acid-Base Equilibrium↗
PubMed1977

Ebstein's anomaly--anaesthetic problems. A case report.

A patient with Ebstein's anomaly undergoing anaesthesia for the operation of hysterectomy is reported. The considerations relating to the risk of an increased right-to-left intracardiac shunt are discussed. The patient was anaesthetized successfully with a combination of nitrous oxide, droperidol and fentanyl.

Adult↗
PubMed1976

Anesthesia for cesarean section III: effects of epidural analgesia on the respiratory adaptation of the newborn in elective cesarean section.

A rise in fetal Paco2 was observed after elective cesarean section in patients anesthetized both with a barbiturate and with nitrous oxide/oxygen. Epidural analgesia seemed to be a good alternative in order to attain better blood gas values in the newborn infant. Fourteen healthy mothers and their infants were studied in connection with elective cesarean section. Epidural analgesia with plain bupivacaine 0.75% was used. Doses varied between 90 and 120 mg. The time between the epidural injection and delivery was around 50 min. In six cases the fetal heart rate was registered continuously. Most of the mothers were sedated with diazepam intravenously or fully anesthetized, after delivery. The mothers were interviewed later. The respiratory adaptation of the infants was studied by blood gas and acid-base measurements in repeated arterial samples during the first 3 hours of life. A comparison was made with a group previously studied, where general anesthesia with a barbiturate, nitrous oxide/oxygen was the method used. The present material showed no differences concerning Pao2 and Paco2 but clearly indicated a tendency towards an earlier normalization of the initial metabolic acidosis. Mothers showed a respiratory alkalosis which was overcompensated by the metabolic component. Maternal blood pressure falls were observed in four cases, and fetal effects could be detected. Although epidural analgesia has a more favorable effect upon the newborn's metabolic component, both the compared methods allow good respiratory adaptation provided they are used correctly. Mothers can be given the opportunity to choose between being conscious or asleep when their child is delivered.

Adaptation, Physiological↗
PubMed1976

Anesthesia for cesarean section IV: placental transfer and neonatal elimination of bupivacaine following epidural analgesia for elective cesarean section.

Epidural analgesia with bupivacaine was used for elective cesarean section, and repeated maternal and neonatal blood samples were collected over 24 h for calculation of drug concentration. A gas-chromatogrphic micro-method was used for the analysis. The aim of this investigation was to evaluate the placental transfer and the elimination rate of the drug. No signs of systemic toxicity were observed in any mother or child, despite relatively high blood concentrations. The fetal-maternal ratio of concentrations at delivery was higher than in previous studies, most probably due to the protein-binding characteristics of bupivacaine and the dosage used. The biological half-life of the rapid phase of elimination (alpha-phase) in the newborn was shorter than in the mother (P less than 0.002), indicating a more rapid distribution process. The half-life of the slow phase of elimination (beta-phase) in the newborn was of the same magnitude as in the mother, indicating that neonatal elimination processes of bupivacaine may be well developed at birth.

Adult↗
PubMed1976

Anesthesia for cesarean section V: effects of enflurane anesthesia on the respiratory adaptation of the newborn in elective cesarean section.

The new anesthetic inhalation agent, enflurane, is supposed to allow rapid induction and recovery. Experinece with this agent in obstetrics is limited. Enflurane was therefore studied in 14 pregnant women undergoing elective cesarean section. Its effects upon the respiratory adaptation of the newborn infants were followed during the first 3 hours, as judged by oxygen tensions and acid-base balance measurements in serial neonatal arterial samples. Results were compared with those from a previously studied group of women anesthetized with a barbiturate and nitrous oxide-oxygen. There were no differences with respect to oxygen tension. Carbon dioxide values in the enflurane group were higher than those in the barbiturate group. In comparison with the barbiturate group the enflurane group of babies had lower BD values, which is a sign of a better metabolic state post-partum. Mothers anesthetized with enflurane were satisfied with the method, especially for the post-operative period.

Adaptation, Physiological↗
PubMed1975

Anesthesia for cesarean section II: effects of the induction-delivery interval on the respiratory adaptation of the newborn in elective cesarean section.

Ten healthy mothers and their infants were studied in connection with elective cesarean section. Anesthesia was induced with 250-300 mg hexobarbitone followed by 100 mg succinylcholine for endotracheal intubation. The surgeon started the operation when the eyelid reflex disappeared, and delivered the baby as quickly as possible. Mean induction-delivery (I-D) interval was 2 min 45 s. Anesthesia was then deepened with further barbiturate, diazepam and methoxyflurane, and alcuronium used as muscle relaxant. The respiratory adaptation of the infant was studied by blood gas and acid-base measurements in repeated arterial samples during the first three hours of life. The mothers were interviewed after 3-12 months. A comparison was made with another barbiturate group with a longer I-D interval (x = 9 min 10 s). The present material showed initially higher PaO2 lower PaCO2, higher pH and less base deficit (BD), which relfected the maternal state at delivery. After 10-30 min, the results approached equivalence, though the babies in the short I-D group showed a tendency toward normalization of metabolic acidosis earlier. At the interviews, two mothers complained of pain during skin incision, and two of nightmares. Anesthesia with barbiturate for cesarean section with the I-D intervals studied in both groups allowed good respiratory adaptation in the infants. There is, neverless, the need for an adequate period of time between induction and the start of the operation in order to minimize the risk for maternal awareness.

Adolescent↗