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At least 127 records · Page 7Linked to original sources
PubMed1985

[A study on spinal anesthesia for cesarean section--with special reference to left uterus displacement device (LUDD)].

UNLABELLED: In this study, 303 cases of cesarean section by spinal anesthesia with the application of LUDD were studied to find the relationships between induction to delivery time (I-D time) and Apgar score (Ap-S), level of anesthesia and changes in maternal circulation and also to observe changes in feto-maternal acid base status, feto-maternal CO2 metabolism monitored with an Anesthesia & Brain activity Monitor (ABM) and post anesthesia complications. RESULTS: The use of LUDD as a prophylactic measure to prevent maternal hypotension was very effective. The elevation of anesthesia level always involved the risk of maternal hypotension even when the LUDD was used. A slight drop in blood pressure during the short period before the infant was delivered did not adversely affect the AP-S, but prolonged I-D time did affect the clinical condition of the infant and probably promoted acidosis. Administration of 100% O2 induced mild maternal acidosis but, for the short period before delivery, the fetal oxygenation and CO2 metabolism were smooth with reduced acidosis. Since there was a close correlation between maternal PECO2 and PaCO2 and PCO2 of the maternal blood (MA, MV) and umbilical blood (UA, UV) were also correlated, the continuous monitoring of PECO2 with an ABM was deemed to be very useful in anesthesia for cesarean section. In the 303 cases studied, a case of headache was the only post-anesthesia complication.

Acid-Base Equilibrium↗
PubMed1985

[Rhabdomyolysis as a late complication of anesthesia--a case of malignant hyperthermia?].

Rhabdomyolysis is usually known to the anaesthetist, who may be confronted with this acute, life-threatening complication during anaesthesia. However, also the medical specialist ought to be familiar with the clinical picture of malignant hyperthermia, since rhabdomyolysis may occur as a late post-anaesthetic complication. Even in oligo-symptomatic and protracted cases of malignant hyperthermia, the case history, electromyogram, exclusion of other possible causes of rhabdomyolysis and, if possible, muscle biopsy contribute to the confirmation of the diagnosis. If a muscle biopsy is not available then a platelet bioassay may substantiate the diagnosis.

Adult↗
PubMed1987

Legal abortion mortality in the United States: 1972 to 1982.

Between 1972 and 1982, 186 women died as a result of legal abortion in the United States. The overall death rate resulting from legal abortion dropped nearly fivefold, from 4.1 per 100,000 abortions in 1972 to 0.8 in 1982. Women who were older, black, of high parity, and had abortions at a later gestational age were at increased risk of death throughout the 11 years of surveillance. During this period, the death rate decreased for abortions at all stages of gestation; the greatest decrease was with abortions performed during the second trimester. For the entire interval, mortality rates were highest for abortions performed by hysterotomy or hysterectomy and lowest for abortions performed by curettage. Before 1977, the most common causes of abortion-related death were infection, hemorrhage, and general anesthesia complications, respectively. Thereafter, hemorrhage became the most common cause of abortion-related death, followed in number by general anesthesia complications. Our findings suggest that there has been a marked decrease in septic legal abortion deaths, but potentially preventable deaths from general anesthesia and hemorrhage remain an important concern. Use of general anesthetics during first-trimester abortions should be carefully reviewed.

Abortion, Legal↗
PubMed1988

Postoperative pulmonary complications: general anesthesia with postoperative parenteral morphine compared with epidural analgesia.

In a prospective study, patients undergoing abdominal cancer surgery were randomly allocated to receive either general anesthesia with fentanyl intravenously and postoperative analgesia with parenteral morphine (GA group) or general anesthesia combined with epidural bupivacaine and epidural morphine for postoperative pain relief (EP group). Analgesia was tested on a visual pain scale. Pulmonary complications were evaluated by clinical complications, blood gas analysis, x-ray film changes, and pulmonary volumes (vital capacity, forced expiratory volume in 1 second). Measurements were performed on the day before the operation and on the first 5 postoperative days. In the EP group the pain relief was significantly better on the first day (p less than 0.03). Whatever the criteria used, the rates of pulmonary complications were similar in the two groups: clinical complications 21% versus 26%, radiologic complications 50% versus 64% for GA and EP groups, respectively. Postoperative PaO2 and spirometric values were similar in the two groups. Postoperative epidural analgesia may improve the patient's comfort but does not decrease the incidence of pulmonary complications.

Abdomen↗
PubMed1997

[Malignant hyperthermia as a complication of anesthesia: predisposition is hereditary].

The frequency of malignant hyperthermia in the Netherlands is about 1 in 200,000 anaesthesias. Five times a year, an anaesthetic procedure will be complicated by a malignant hyperthermic metabolic disturbance, which can cause death if treatment is not instituted rapidly, by the administration of dantrolene. Suxamethonium and all the anaesthetic vapours can trigger such a reaction. Malignant hyperthermia patients are healthy patients who have a mutation of the ryanodine receptor gene RYR. Predisposition to malignant hyperthermia is inherited as an autosomal dominant condition. So far a genetic malignant hyperthermia test is not available because of genetic heterogeneity. The in-vitro contracture test in skeletal muscle is currently used as a diagnostic test for malignant hyperthermia. Patients who are likely to be at risk based on a clinical grading score, and family members with at least a 25% chance of inheriting malignant hyperthermia, are eligible for this test.

Calcium Channels↗
PubMed1987

[Complications of anesthesia in elderly patients].

Progress in surgery and anesthesia has contributed to lowering operative risk and expanding the indications for operations in higher age groups. The goal of treatment in the elderly is to achieve the best possible degree of reducing discomfort and increasing personal independence. Methods. A brochure with a clinical study on 1,021 patients chosen at random shows the frequency of complications arising during the peri- and post-operative course in patients around 60 years of age and older. Operative areas were general and emergency surgery, vascular surgery, neurosurgery, and urology. Operations were carried out in regional or general anesthesia. Patients were divided into groups below and above age 60. Evaluation of the data was carried out according to an integrated data processing concept. This program enables quantitative and qualitative data to be combined at will, taking into consideration that evaluating criteria can be varied considerably. Results. The results demonstrate that patients over 60 have significantly more complications than patients under 60. Analysis of the influence of the factors associated with surgical risk reveals that factors related to the operation such as type, length, and extent do not increase the risk as much as the numerous accompanying illnesses in both age groups. As far more elderly patients are affected by multimorbidity, the conclusion may be drawn that the increased risk observed is not due mainly to age, but rather to the patient's condition prior to surgery. The results indicate clearly that an exact analysis of the initial condition as well as avoiding failure or malfunction of certain organs must have priority in both age groups.

Aged↗