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Query: UMLS:C0344307 (analgesia)
 28,200 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

213 caesarean sections and 157 hysterectomies were carried out in gilts and sows with different body weight (table I). The neuroleptic Azaperone and the hypnotic Metomidate were used for anaesthesia with different administration (table II). Local analgesia and premedication with Atropine. The duration of the anaesthesia was 45 minutes and where prolongation was necessary, Metomidate, Azaperone or barbiturates were used alone or in combinations once or more. The indications (table III) for caesarean section were retarded birth in 70 sows, dislocation of uterus in 74 sows and in 69 sows by other indications. Hysterectomy was indicated by retarded birth in 93 sows, dislocations of uterus in 40 cases and in 24 cases by other indications. In 183 operations (table IV) 1006 living piglets were delivered, and 703 were alive at discharge (70%). The chances of survival depends on the composition of the litter, in litters of piglets alive only, 76% survived at discharge; in litters consisting of both alive and stillborn 69% survived and 59% survived in litters consisting of piglets alive and post mortem piglets. The total survival of the sows was 78%, 80% after caesarean section and 76% after hysterectomy. It is pointed out that most of the patients operated were in a very late phase of birth.
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PMID:[Caesarean section in sows anesthetized with Azaperone and Metomidate (author's transl)]. 0 2

Acupuncture was used on 20 patients to induce analgesia for instrumental inspection of the uterus. The procedure was successful in 80% of cases; in 12 patients single manual manipulation of the needles was used, without electrical stimulation. There was, after the procedure, less bleeding and less pain than after regular anesthesia. Acupuncture is to be recommended in all instances in which anesthesia would entail a risk, or would generally not be advisable.
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PMID:[Acupuncture analgesia in instrumental examinations of the uterus]. 45 Mar 13

10 patients underwent intravaginally (15S)-15-methyl-prostaglandin F2 alpha-methylester application to induce abortion. The last menstrual bleeding had occurred less than 50 days prior to the operation and NCG was determined in urine samples in all cases. The dissolution of the amniotic sac occurred within 4-5 hours after application, and the remains were removed by curettage in 7 cases, usually without narcosis or analgesia. The procedure failed in 2 cases, one due to ectopic pregnancy and one due possibly to bleeding from the uterus after insertion of a catheter, which may have inhibited resorption of the prostaglandin.
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PMID:[Drug-induced abortion in early pregnancy with intravaginally administered (15S)-15-methyl-prostaglandin F2 alpha methylester (15-S-PGF2 alpha) (proceedings)]. 57 13

An elective left flank Caesarean operation was performed on 56 Hereford cattle and the influence of various surgical techniques on the postoperative progress assessed. A paravertebral nerve block produced effective analgesia in all layers of the abdominal wall of all cattle. In contrast, tissue infiltration, in the form of an inverted L block, did not produce analgesia of the peritoneum and was generally only partly effective in the muscle layers of fat animals. The use of spasmolytic drug facilitated handling of the uterus. Xylazine, when given to unmanageable animals, noticeably increased uterine tone even when used in conjunction with a spasmolytic. Three animals (5.4%) died from generalised peritonitis. Peritoneal adhesions developed in 29 animals (51.8%) and minor wound dehiscence and/or suture infection occurred in 8 animals (14.1%). Postoperative subcutaneous emphysema developed in ;23 cattle (41%). The absence of sutures in the peritoneum was associated with a significant increase in the occurrence of subcutaneous emphysema. Although the prevalence of retained foetal membranes was high this did not seem to influence the postoperative progress of the animal.
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PMID:Elective caesarean operation in Hereford cattle. 58 75

Ketamine, currently being evaluated as an obstetric anaesthetic agent, is said to provide analgesia without depression of the protective airway reflexes or depression of the respiratory or cardiovascular systems. We have studied the effects of ketamine on the uterine blood flow, the foetus and the newborn in five monkeys (Macaca nemistrina). Uterine blood flow, (UBF) was measured by the steady-state infusion technique using tritiated water as the indicator. All of the variables were measured during a control period and again at 10 and 90 min after the administration of ketamine in doses of 2 mg/kg in three monkeys or 1 mg/kg in two. Maternal respiration was maintained at normal physiological levels without significant variation. The maternal mean arterial pressure (MAP), cardiac output (CO), and stroke volume (SV) did not change significantly, but heart rate (HR) did increase significantly following the injection of ketamine and remained increased for the duration of the study. UBF, a-v oxygen difference, and the oxygen consumption of the uterus and its contents remained stable throughout. During the intrauterine period the foetus did not seem to be affected by the two doses of ketamine. However, the three newborn monkeys delivered of the mothers who had reveived ketamine 2 mg/kg had profound respiratory depression. This was not seen in the two infants delivered from mothers receiving 1 mg/kg. Others have shown that neonatal depression is dose- and time-related. We conclude that ketamine should be administered to obstetric patients in small single doses or by continuous infusion in very low concentrations.
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PMID:Respiratory depression in newborn monkeys at Caesarean section following ketamine administration. 81 Dec 35

The study objective was to determine the effectiveness and safety of a single high dose (40 mg) of intraamniotically administered prostaglandin F2alpha (PGF2alpha). A total of 33 women in their 14-20th week of pregnancy were selected for the study. The outcome was considered successful if the fetus and/or placenta were expelled from the uterus within 48 hours. If the fetus and placenta were expelled completely through the cervical canal the trial was recorded as complete abortion. If the placenta was retained within the uterus, completely or partially, the trial was recorded as incomplete abortion. The patients' mean age was 22.6 years. 27 patients were under 28 years of age, and 9 patients were under age 20. 25 patients were African, 2 Caucasian, and 4 Asian. 2 others were of mixed race. The mean parity of the patients was 1.4 previous pregnancies with a standard error of +or- 1.4. 17 women were nullipara; 16 women were multipara. There was 1 case of technical failure in the series, an obese Asian patient with a 16 week pregnancy in whom difficulty was experienced in entering the amniotic sac. A bloody tap during amniocentesis was obtained in 4 patients. 28 of the 32 patients aborted within 48 hours, showing a success rate of 87.5%. At the end of the first 24 hour period, 19 patients (59.4%) had aborted and an additional 9 patients (28.1%) aborted during the following 24 hours. The mean induction abortion interval was 19.4 hours. Multiparous patients aborted more frequently and in a shorter period of time than did nulliparous patients. 92.3% of the multiparous patients aborted by 30 hours; only 84.2% of the primigravida had achieved this in 36 hours. In the successful group abortion was complete in 13 patients (46.4%). In the other 15 patients (53.6%) the placenta was partially or completely retained necessitating surgical evacuation. Minor side effects were observed in 28 patients (87.5%). None of these side effects required analgesia in the form of intramuscular pethidine. Gastrointestinal disturbances were common. Vomiting occurred in 11 patients. Diarrhea occurred in 3 patients. No instances of cervical laceration or cervicovaginal fistula were observed. Bleeding was minimal in 27 patients (84.4%). In another 5 patients the amount of bleeding was moderate. In the majority of patients bleeding ceased with 2 weeks after discharge from hospital. None of the patients needed hospital readmission. No signs of vaginal or pelvic infection or delayed uterine involution were observed.
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PMID:Induction of second-trimester abortion with a single dose (40 mg) of intra-amniotic prostaglandin F2a. 92 82

During the period January 1969 to November 1974, in a total of 39,800 deliveries, there were two sets of quadruplets. Both parturients had been taking ovulation-inducing drugs. Maternal problems were distended abdomen and heavy uterus, causing supine hypotension and lordosis; toxemia of pregnancy; increased possibility of hemorrhage before, during and/or after delivery; edema of the back; mental depression. The fetal problems were prematurity; intrauterine growth retardation; increased possibility of transfusion syndrome and prolapsed cord; increased obstetric manipulation. An adequate number of obstetricians, pediatricians, anesthesiologists, and nurses, necessary equipment, and blood and blood components should be available. Early hospitalization is necessary. Close observation of the patient before, during, and after delivery is essential. The patient should stay on her side throughout the labor. General anesthesia may add to fetal depression and increase the possibility of uterine atony. Spinal or lumbar epidural anesthesia may be difficult because of the associated lordosis and back edema. Caudal block allowed intrauterine manipulation; provided adequate analgesia, permitted high FIO2 administration, and did not interfere with voluntary bearing down when required.
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PMID:Caudal analgesia for quadruplet delivery. 94 32

A review of some policies of clinical practice, adopted in the light of experience, is presented. These include the inadvisability of attempting to obtain a precise segmental block during the first stage of labour; the urgent need to avoid compression of the inferior vena cava by the uterus during labour and at the time of delivery; a preference for the routine use of bupivacaine in concentration of 0.375%, and for the plain solution irrespective of the concentration employed; and the advocacy of providing lumbar extradural analgesia in cases of breech presentation and multiple pregnancy. The list of contraindications has been considerably reduced during the past few years.
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PMID:Patient management during extradural anaesthesia for obstetrics. 114 1

We currently consider the external version of the fetus from a breech to a vertex presentation near term the best solution to the disadvantages of a breech delivery for mother and child. Version at such a late time in gestation is only possible with the aid of the tocolytic relaxation of the uterus as recommended by us. This method offers two important advantages over the conventional method of external version, the performance of which after the 34th week of gestation has been discouraged because of the poor chance for success: 1. Because of the relatively decreased intrauterine space during the last month of pregnancy the fetus will revert less readily to a breech. 2. In the event of a complication during external version the immediate operative delivery of the mature infant near term is possible. After the presentation of the fetus has been diagnosed by ultrasound the mother is given 20-50 micrograms Fenoterol (Partusisten) intravenously simultaneously with an inhalation analgesia. The version itself is effected by positioning the hands of the operator against the fetal forehead and by turning the infant as in a backwards roll. If this fails, the dose of the tocolytic agent may be increased. In cases with extended legs the chances for success appear to be decreased. The completed version should be confirmed with an ultrasound examination and the undisturbed status of the fetus should be documented with a cardiotocogram immediately after the version. The following results were achieved: The external version was successful in 43 of 57 pregnant women (75%). If the material is selected more critically, over 80% of the attempted versions should be successful. We have now delivered 40 infants as vertex presentations after a previously diagnosed breech presentation. The frequency of breech deliveries in our hospital has decreased by 2.6% from 5.4% to 2.9% since the introduction of version. The decrease is statistically significant. Convincing evidence that version has decreased fetal risk from breech delivery is found in a comparison of the newborn status. The decrease in the percentages of clinically depressed and acidotic newborns is also statistically significant. The failure rate does not appear to increase with increasing gestational age. There is no correlation between parity and failure or between maternal age and failure. So far we have seen no serious complications. In 5 of 24 cardiotocograms recorded a transient fetal bradycardia occurred immediately after the version which disappeared after a few minutes of maternal lateral position.
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PMID:External cephalic version under tocolysis. 118 81

Fetal reduction techniques, experiences at Northwestern University of Evanston, Illinois, USA, and ethical issues are discussed. The use of fetal reduction pertains to higher order multiple pregnancies due to successful fertility treatments. The risk associated with multifetal pregnancy is preterm delivery i.e., 29-31 weeks for quadruplets. In addition, survivors often have a high risk of congenital abnormalities and complications related to prematurity. 1978 marked the 1st time selective termination was possible. Other terms include "selective" birth, reduction, feticide, abortion, and multiple pregnancy reduction. The procedure takes place in the 1st or 2nd trimester, and procedures are similar to an elective abortion but with different techniques. Although there are many techniques, the preferred one is transabdominal cardiac puncture and injection of potassium chloride. A highly skilled ultrasonographer is essential for a successful technique. The complexity of the technique is one where the physician from a 2-dimensional screen must envision a 3-dimensional picture of the uterus and contents. Accurate needle placement is important. The reports from 7 clinical trials using the intracardiac potassium chloride technique are presented. The Northwestern experience includes 25 reductions between 1987-91 using fentanyl and midazolidocaine analgesia and general anesthesia with 1% lidocaine. Gestational age ranged from 9 to 13 weeks. There was total loss in 2 cases and deliveries in 8 cases including neonatal death of a very preterm set of twins. At or = 37 weeks, there were 11 pregnancies. 11 patients were or = 35 years, and 4 of the 20 30 years. In 33% of cases, only 1 pregnancy was left, which is dissimilar to other studies. Many difficulties may be faced with a complete pregnancy loss where there is a lack of support for the decision for fetal reduction. 2 concerns are mentioned in the ethical debate: the adequacy of counseling and the criteria for determining how many reductions per pregnancy. Difficulties arise in physician counseling when patients are unable to assimilate complex and detailed information, and physicians may not accurately convey information. Institutions may bias patient counseling. When an abnormality exists, the decision is easy; but with multiple normal development, the recommendation is twins. The Northwestern recommendation involves patient and family decisions and joint discussion of risk. The likelihood of severely premature delivery and maternal morbidity should also be considered, as well as the medical cost incurred with delivery and care of preterm multiple infants i.e., 1.2 million dollars for delivery of quads at 27 weeks. Science should be directed to reducing multiple pregnancies by refining technique and using fetal reduction as an interim technique. Fetal reduction is not appropriate for all multiple pregnancies.
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PMID:Fetal reduction: is this the appropriate answer to multiple gestation? 134 38


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