scholarly journals Effects of remifentanil and dexmedetomidine on the mother’s awareness and neonatal Apgar scores in caesarean section under general anaesthesia

2018 ◽  
Vol 46 (5) ◽  
pp. 1846-1854 ◽  
Author(s):  
Kenan Kart ◽  
Ayse Hanci
Keyword(s):  
Caesarean Section ◽  
General Anaesthesia ◽  
Bispectral Index ◽  
Elective Caesarean Section ◽  
Control Group ◽  
Depth Of Anaesthesia ◽  
Apgar Scores ◽  
Routine Monitoring ◽  
Number Of Patients ◽  
Group 2

Objective This study aimed to compare the effects of remifentanil and dexmedetomidine on awareness during the induction of general anaesthesia. Material and Methods Ninety patients scheduled for elective caesarean section under general anaesthesia were included and randomly divided into three anaesthesia groups: 2 mg/kg propofol (control group); 2 mg/kg propofol and 1 µg/kg dexmedetomidine (dexmedetomidine group); and 2 mg/kg propofol and 1 µg/kg remifentanil (remifentanil group). All patients received routine monitoring, and Apgar scores at 1 and 5 minutes were recorded. The bispectral index and the isolated forearm technique were used to determine the depth of anaesthesia. Results Bispectral index values at skin and uterine incisions and at delivery were similar among the groups. The number of patients who responded positively to the isolated arm technique during the induction period was also similar. One-minute Apgar scores in the control group were significantly lower and 5-minute Apgar scores significantly higher than those in the other groups. Conclusion The effects of remifentanil and dexmedetomidine added to propofol on maternal awareness, neonatal Apgar scores, and bispectral index values were similar compared with propofol alone. However, it was observed that remifentanil controlled the haemodynamic responses to sympathetic stimuli in a better manner than dexmedetomidine.

scholarly journals An appraisal of computed tomography pelvimetry in patients with previous caesarean section

2000 ◽  
Vol 6 (2-3) ◽  
pp. 260-264
Author(s):  
Y. M. Abou Ghazzeh ◽  
R. Barqawi
Keyword(s):  
Computed Tomography ◽  
Birth Weight ◽  
Caesarean Section ◽  
Caesarean Delivery ◽  
Elective Caesarean Section ◽  
Emergency Caesarean Section ◽  
Control Group ◽  
Previous Caesarean Section ◽  
Apgar Scores ◽  
Emergency Caesarean

This study was conducted to determine the value of computed tomography [CT] pelvimetry in patients with previous caesarean section. Of 219 pregnant women with one previous caesarean section, 100 had antenatal CT pelvimetry and a control group of 119 women had no CT pelvimetry. In the CT pelvimetry group, 51.0% delivered by caesarean section, 28.0% underwent elective caesarean section for contracted pelvis based on the findings of CT pelvimetry and 23% underwent emergency caesarean section after a trial labour. In the control group, 21.8% underwent emergency caesarean section. The differences in birth weight and Apgar scores between the groups were not statistically significant. CT pelvimetry increased the rate of caesarean delivery, suggesting that CT pelvimetry before a vaginal birth after a previous caesarean delivery is of limited value

Cesarean section incisional infiltration with lidocaine and Epinephrine versus Lidocaine alone in reducing postoperative pain. A randomized controlled double-blinded clinical trial

QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Hazem F El-Shahawy ◽  
Sherif F El-Mekkawi ◽  
. Haitham F Mohmmed ◽  
Hend M Afifi
Keyword(s):  
Caesarean Section ◽  
Cesarean Section ◽  
General Anesthesia ◽  
Local Anesthesia ◽  
Breast Feeding ◽  
Local Anesthetic ◽  
Elective Caesarean Section ◽  
Control Group ◽  
Cesarean Section Delivery ◽  
Anesthetic Effect

Abstract Background Cesarean section delivery is becoming more frequent. Childbirth is an emotion-filled event and the mother needs to bond with her newborn baby as early as possible. Any intervention that leads to improvement in pain relief is worthy of investigation Aim of the Work to assess the efficacy and safety adding ef Epinephrine to lidocaine 2% in dose-related manner 1:200.000 in prolongation of anesthetic effect of lidocaine as a local anesthetic to reduce post; caesarean section pain after general anesthesia. Patients and Methods A total number of 200 women planned for elective caesarean section at Shams University Maternity Hospital Was recruited, 2 groups were randomized with a study group included 100 women received lidocaine 2% and epinephrine in dose-related manner and a control group included 100 women received lidocaine 2% only. Results women who received lidocaine and epinephrine were more satisfied and hadsignificant more time after caesarean section free of pain in comparison to women who received lidocaine only by 120 minutes. Also. adding Of epinephrine helped in decrease in amount of analgesic consumption after caesarean section. Women who received lidocaine and epinephrine started breast feeding and mobilization earlier than women who received lidocaine only. Epinephrine prolonged the action of lidocaine as a local anesthetic, this prolongation of action of local anesthetic had a significant effect in early mobilization and breast feeding and decrease in cost of analgesics. Nobody in our candidate had a post-operative infection, past operative pyrexia, Allergic reactions tar general anesthesia or complications with local anesthesia. Conclusion Adding of epinephrine to local anesthetics (such as lidocaine 2% in dose-related manner 1:200.0000) prolonged anesthetic effect by more than double of its original anesthetic time, This prolongation on anesthetic effect of local anesthesia by epinephrine helps in eariy mobilization; early breast feeding and less hospital duration stays. No complications (local nor systemic) developed with local infiltration of post-caesarean section incision with lidocaine 2% even aficr adding epinephrine in dose-related manner 1:200.000

scholarly journals Prophylactic Intramuscular Ephedrine Prior to Caesarean Section

1992 ◽  
Vol 20 (4) ◽  
pp. 448-452 ◽  
Author(s):  
C. C. Rout ◽  
D. A. Rocke ◽  
R. Brijball ◽  
R. V. Koovarjee
Keyword(s):  
Caesarean Section ◽  
General Anaesthesia ◽  
Control Group ◽  
Double Blind Study ◽  
Double Blind ◽  
Maximum Increase ◽  
Arterial Ph ◽  
Maternal Hypertension ◽  
Acid Base Status ◽  
Umbilical Arterial Ph

Thirty healthy parturients, having given informed consent, were randomly allocated in a double-blind study to receive an intramuscular injection of either 0.9% sodium chloride (control), ephedrine 25 mg, or ephedrine 50 mg, 30 minutes prior to general anaesthesia for caesarean section. Nine patients (90%) in the 50 mg group and five patients (50%) in the 25 mg group demonstrated reactive hypertension of 20% or greater from control. The mean maximum increase in the 50 mg group was 28.2% (range 4.4–38.3%). Maternal pH was significantly lower (P = 0.03) in the ephedrine 50 mg group. Neonatal acid base status was significantly impaired in the ephedrine 50 mg group with umbilical venous pH (P = 0.0001) and umbilical arterial pH (P = 0.001) being significantly lower than the control group. The associated increase in umbilical arterial base deficit suggests a metabolic component due to fetal asphyxia related to decreased uterine blood flow. We conclude that the prophylactic administration of intramuscular ephedrine prior to spinal anaesthesia is associated with an unacceptably high incidence of maternal hypertension, and should the spinal fail and general anaesthesia be required, also results in adverse neonatal biochemical changes. The technique is therefore not to be recommended.

scholarly journals The Contrasting Effects of Enflurane on Transplacental Exchange after Methohexitone and Ketamine Induction of Anaesthesia for Caesarean Section

1978 ◽  
Vol 6 (3) ◽  
pp. 239-242 ◽  
Author(s):  
J. W. Downing ◽  
P. J. C. Houlton ◽  
J. G. Brock-Utne ◽  
R. J. R. Buley
Keyword(s):  
Caesarean Section ◽  
Beneficial Effect ◽  
General Anaesthesia ◽  
Elective Caesarean Section ◽  
Volatile Agent ◽  
Inhalational Agent ◽  
Induction Of Anaesthesia ◽  
Uterine Relaxation

Supplementation of general anaesthesia with enflurane 0.6% before delivery of the foetus by elective Caesarean section, produced contrasting effects after methohexitone and ketamine administration. Enflurane, an inhalational agent causing vasodilation and uterine relaxation, enhanced maternal to foetal transplacental exchange following methohexitone induction of narcosis. This beneficial effect of the volatile agent was not seen after ketamine, a vasoconstrictor drug which stimulates myometrial contraction.

scholarly journals Postoperative Analgesia for Haemorrhoid Surgery

1983 ◽  
Vol 11 (1) ◽  
pp. 27-30 ◽  
Author(s):  
D. A. Pybus ◽  
B. E. D'Bras ◽  
G. Goulding ◽  
H. Liberman ◽  
T. A. Torda
Keyword(s):  
Postoperative Pain ◽  
General Anaesthesia ◽  
Postoperative Analgesia ◽  
Normal Saline ◽  
Morphine Sulphate ◽  
Control Group ◽  
Treatment Groups ◽  
Number Of Patients ◽  
Caudal Analgesia ◽  
The Mean

Seventy patients undergoing haemorrhoidectomy under general anaesthesia were randomly allocated to one of five treatment groups in order to compare the effectiveness of various caudal agents in the control of postoperative pain. Four groups were given a caudal injection of either 2% lignocaine, 0.5% bupivacaine, 2% lignocaine + morphine sulphate 4 mg or normal saline + morphine sulphate 4 mg, while the fifth (control) group did not receive an injection. The number of patients requiring postoperative opiates was significantly higher in the lignocaine group than in the morphine (p <0.05) and morphine-lignocaine (p <0.05) groups. No agent significantly reduced the number requiring opiates. In those who received opiates, the mean analgesic period was 228 minutes in the control group, and was significantly longer following bupivacaine (577 min, p <0.01), morphine-lignocaine (637 min, p <0.05) and morphine (665 min, p <0.01). The mean analgesic period following lignocaine (349 min) was not significantly different from control. The incidence of catheterisation was lowest in those patients who did not receive caudal analgesia.

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