ABSTRACT
BACKGROUND: Studies of gastric volume and pH during various stages of pregnancy have not confirmed a consistently evaluated volume or acidity, but point out that these patients may be at risk. The aim of this study was to evaluate the volume and acidity of gastric contents in pregnant and non-pregnant patients. METHODS: Thirty pregnant patients scheduled for elective cesarean section under spinal anesthesia (pregnant group) and thirty non-pregnant female patients that underwent gynecologic surgery with general anesthesia (non-pregnant group) were enrolled. Preoperative fasting times and anxiety score, using a visual analogue scale from 0 to 10, were obtained from all patients. After the induction of anesthesia, gastric contents were aspirated gently using a 14-F multiorifice nasogastric tube and syringe. Gastric volume and acidity were measured. RESULTS: The gastric volume (ml) in the pregnant group was 42.8 +/- 35.0 (mean +/- SD, range: 5-130), and in the non-pregnant group 15.8 +/- 11.9 (range: 3-50). The gastric pH in the pregnant group was 2.1 +/- 0.9 (range: 1.3-5.4), and in the non-pregnant group 2.8 +/- 1.7 (range: 1.3-6.5). CONCLUSIONS: We confirm that pregnant women have more acidic and greater gastric volumes than non-pregnant women.
Subject(s)
Female , Humans , Pregnancy , Anesthesia , Anesthesia, General , Anesthesia, Spinal , Anxiety , Cesarean Section , Fasting , Gynecologic Surgical Procedures , Hydrogen-Ion Concentration , Pregnant Women , SyringesABSTRACT
It has been emphasized that continuous monitorings of arterial pressure, central venous pressure, electrocardiogram, blood gas analysis, serum electrolytes, body temperature, hematacrit and urinary output are mandatory for the anesthetic management of pheochromocytoma. In addition, it is necessary for the anesthetists to understand pharmacologic effects of drugs which influence the peripheral vascular tone and cardiac excitability. We experienced recently anesthetic management of two cases of pheochromocytoma; one raised problems of ventricular arrhythmias and hypertension that aggravated nature of arrhythrmias by increasing blood pressure and responded favorably to treatment with propranolol and trimetaphan. Tumor of this case originated from abdominal aortic wall. The other was managed by injection of d-tubocurarine which induced narrowing of pulse pressure by depletion of increasing systolic pressure and accompanied tachycardia without cardiac decompensation. We have reported proper anesthetic managements of two cases of pheochromocytoma with N2O O2-halothane anesthesia and reviewed literatures in discussion.
Subject(s)
Anesthesia , Arrhythmias, Cardiac , Arterial Pressure , Blood Gas Analysis , Blood Pressure , Body Temperature , Central Venous Pressure , Electrocardiography , Electrolytes , Hypertension , Pheochromocytoma , Propranolol , Tachycardia , Trimethaphan , TubocurarineABSTRACT
Two cases of anesthetic experience with tracheoesophageal fietula with esophageal atresia have-been reported and the literature reviewed. On the fifth day of life, anesthesia was induced and maintained with nitrous oxide-oxygen- halothane using Ohio infant circle absorber, preceded by awake endotracheal intubation with the aid of intramuscular injection of succinylcholine chloride following preliminary oxygenation. Gastro-stomy was performed prior to surgery. Tracheoesophageal fistula was divided and the esophagus anastomosed. In the first case surgical manipulation of the lungs and trachea caused complete airway obstruction and momentary cardiac arrest, which was successfully treated with I.V. calcium gluconate and sodium bicarbonate. Both infants made otherwise uneventful recoveries. The importance of preliminary gastrostomy, atraumatic intubation, maintenance of adequate ventilation and circulation, frequent suctioning of airway secretions, and of treating pulmonary complications have been stressed.