Dexmedetomidina en anestesia espinal para cesárea / Dexmedetomidine in spinal anesthesia with cesarean

Dexmedetomidina un α- agonista, de amplio uso y popular nivel mundial, que poco conocimiento se tiene sobre su uso de forma intratecal en la población boliviana, de manera especial en pacientes obstétricas. OBJETIVOS: evaluar el efecto de dexmedetomidina intratecal en anestesia obstétrica y observar los efectos secundarios del medicamento. MÉTODOS: ensayo clínico aleatorizado y simple ciego. La muestra fue de 123 pacientes, cada grupo de 41 pacientes cumpliendo ambos criterios. Grupo B (bupivacaina + fentanil); grupo D2 (bupivacaina + fentanil+ dexmedetomidina 2 µg) y grupo B3 (bupivacaina + fentanil+ dexmedetomidina 3 µg). Análisis estadístico: se utilizó el software SPSS® 25 y Excel® 2016. Con un nivel de confianza del 95 % y error muestral del 13 %. RESULTADOS: duración del bloqueo motor fue de 106,5 ± 16 minutos en el grupo B; 142,3 ± 28,2 minutos en el grupo D2 y 145,6 ± 16,7 minutos en el grupo D3. Siendo significativo entre los grupos de estudio (valor p < 0,000). PAM con significancia estadística antes y después del nacimiento. Frecuencia cardiaca significativo a los 15, 30 y 45 minutos (valor p < 0,000; 0,001; 0,004; 0,000 y 0,002). Etilefrina en el grupo B fue de 3,44 ± 1,8 ml; para el grupo D3 fue de 1,8 ± 2,7 ml y grupo D2 fue de 0,85 ± 1,6 ml. CONCLUSIONES: mejor estabilidad hemodinámica con 2 µg dexmedetomidina, menor incidencia de hipotensión, uso de vasopresores, las complicaciones escasas y un excelente estado de sedación materna

Dexmedetomidine an α-agonist, widely used and popular worldwide, with little knowledge about its use intrathecally in the Bolivian population, especially in obstetric patients. OBJECTIVES: evaluate the effect of spinal dexmedetomidine in obstetric anesthesia and observe the side effects of the medication. METHODS: randomized and simple blind clinical trial. The sample consisted of 123 patients, each group of 41 patients meeting both criteria. Group B (bupivacaine + fentanyl); group D2 (bupivacaine + fentanyl + 2 µg dexmedetomidine) and group B3 (bupivacaine + fentanyl + 3 µg dexmedetomidine). Statistical analysis: it was carried out in SPSS® 25 and Microsoft Excel® 2016. With a confidence level of 95% and sampling error of 13%. RESULTS: duration of the motor block was 106,5 ± 16 minutes in group B; 142,3 ± 28,2 minutes in group D2 and 145,6 ± 16,7 minutes in group D3. Being significant among the study groups (p value <0,000). MAP with statistical significance before and after birth. Significant heart rate at 15, 30 and 45 minutes (p value <0,000; 0,001; 0,004; 0.000 and 0,002). Ethylephrine in group B was 3,44 ± 1,8 ml; for group D3 it was 1,8 ± 2,7 ml and group D2 was 0,85 ± 1,6 ml CONCLUSIONS: better hemodynamic stability with 2 µg dexmedetomidine, lower incidence of hypotension, use of vasopressors, limited complications and an excellent state of maternal sedation.

Anesthesia for intrauterine myelomeningocele correction: first successful experience in Peru. Case report / Anesthesia for intrauterine myelomeningocele correction: first successful experience in Peru. Case report

Abstract Introduction: In pregnancies with a diagnosis of fetal myelomeningocele (MMC), studies have shown that prenatal correction, as compared with postnatal correction, results in better outcomes in infancy, requiring less ventriculoperitoneal shunts, and resulting in improved motor function of the lower limbs. However, maternal morbidity, the risk of uterine repair dehiscence, uterine rupture secondary to hysterotomy, and the need for cesarean section are all increased. This case report is the first successful experience of intrauterine repair of a MMC in Peru. Case presentation: We describe the case of a primigravida at 25 weeks of gestation with a diagnosis of fetal malformation (MMC and Arnold Chiari II syndrome) taken to intrauterine correction of the neural tube defect under general anesthesia plus epidural analgesia. Conclusion: The use of total intravenous anesthesia associated with nitroglycerine infusion for uterine relaxation, ethylephrine infusion to maintain maternal hemodynamic stability, and adequate postoperative pain management with epidural analgesia was successful in this case.

Resumen Introducción: En los embarazos con diagnóstico de Mielomeningocele fetal, los estudios han demostrado que la corrección prenatal conlleva a mejores resultados en la infancia que la corrección postnatal, requiriendo menos derivaciones ventrículo peritoneales y mejor función motora de miembros inferiores. Sin embargo se incrementa la morbilidad materna, el riesgo de dehiscencia de histerorrafia, ruptura uterina secundaria a la histerotomía y la necesidad de parto por cesárea. El presente reporte de caso es la primera experiencia exitosa de reparación intrautero de MMC en Peru. Presentación del caso: Describimos el caso de una primigesta de 25 semanas de gestación, con diagnóstico de malformación fetal (Mielomeningocele y Síndrome de Arnold Chiari II) en quien se realizó una corrección intrautero del defecto neural y cuya técnica anestésica fue anestesia general más analgesia epidural. Conclusiones: El uso de anestesia total intravenosa asociado a la infusión de nitroglicerina para la relajación uterina, la infusión de etilefrina para mantener la estabilidad hemodinámica materna y el adecuado manejo del dolor postoperatorio vía epidural fue exitoso en este caso.

Etilefrina para la corrección de la hipotensión arterial materna durante cesáreas bajo bloque subaracnoideo y riesgo de hipoglucemia neonatal, Hospital Guillermo Almenara, Enero a Marzo del 2013 / Etilefrine for correction of maternal hypotension during caesarean section with subarachnoid block and risk of neonatal hypoglycemia, Hospital Guillermo Almenara, January to March 2013

Introducción: El presente estudio analizó casos de gestantes sometidas a bloqueo subaracnoideo (BSA) para cesárea y que necesitaron el uso de etilefrina para la corrección de la hipotensión arterial materna. Métodos: Se incluyeron a las gestantes sometidas a cesárea bajo BSA en el periodo enero a marzo del 2013, en el Hospital Almenara de Lima Perú, se excluyeron a los neonatos inmaduros, con RCIU, hijos de madres diabéticas, con enfermedad hemolítica RH, con asfixia, sepsis, policitemia y/o hipotermia neonatal, y se compararon las glicemias de la primera y segunda hora de vida de los neonatos, agrupados según el factor de exposición (administración de etilefrina a sus madres durante la cesárea), mediante la prueba estadística del t de student y en tablas de contingencia se calculó el riesgo relativo para la exposición. Resultados: La edad promedio para ambos grupos de pacientes es 30 años, la talla promedio del grupo expuesto es 1.55m y del grupo no expuesto es 1.57m, la mediana para el peso del grupo expuesto es 69 Kg y del grupo no expuesto es 72 Kg, la mediana para la edad gestacional del grupo expuesto es 38 semanas y del grupo no expuesto es 39 semanas. El promedio del peso de los neonatos del grupo expuesto es 3318 g y del grupo no expuesto es 3444 g. El promedio de la glicemia en la primera hora de vida de los neonatos del grupo expuesto es 57 mg/dl y del grupo no expuesto es 56 mg/dl; el promedio de la glicemia en la segunda hora de vida de los neonatos del grupo expuesto es 63 mg/dl y del grupo no expuesto es 65 mg/dl. La prueba de t de student para el promedio de las glicemias a la primera y segunda hora de vida de los neonatos, no mostró diferencias significativas entre ambos grupos, pero en las tablas de contingencia se calculó un riesgo relativo para el factor de exposición de 2.68 (IC 95 por ciento 0.68 a 10.47), es decir la exposición es un factor de riesgo pero sin asociación causal. Conclusiones: Existe mayor riesgo de hipoglicemia neonatal...

Background: The present study analyzed cases of pregnant women undergoing subarachnoid block (BSA) for cesarean section and requiring the use of ethylephrine to correct maternal hypotension. Methods: We included pregnant women undergoing cesarean section under BSA in the period January to March 2013, at the Hospital Almenara in Lima Peru, were excluded immature newborns with IUGR, newborns of diabetic mothers with RH hemolytic disease, with asphyxia, sepsis, polycythemia and/or neonatal hypothermia and compared the glucose levels of the first and second hour of life for newborns, grouped according to the exposure factor (ethylephrine administration to their mothers during caesarean section), using the statistical test Student's t contingency tables and calculated the relative risk for exposure. Results: The average age for both groups of patients is 30 years, the average size of the exposed group is 1.55m the unexposed group is 1.57m, the median weight is 69 kg exposed group and the unexposed group is 72 kg, the median gestational age of 38 weeks is exposed group and the unexposed group is 39 weeks. The average weight of the newborns in the exposed group is 3318 g and the unexposed group is 3444 g. The mean blood glucose in the first hour of life of newborns exposed group is 57 mg/dI and the unexposed group is 56 mg/dI, the mean blood glucose during the second hour of life of newborns in the exposed group is 63 mg/dI. and the unexposed group is 65 mg/dI. The Student t test for average blood glucose for the first and second hour of life of newborns showed no significant differences between both groups, but in the contingency tables was calculated relative risk for the exposure factor of 2.68 (95 per cent Cl 0.68 to 10.47), the exposure is a risk factor but no causal association. Conclusions: There is increased risk of neonatal hypoglycemia associated with the use of ethylephrine to correct maternal hypotension during caesarean section under BSA.

Etilefrina en infusión como alternativa para estabilidad cardiovascular en cesáreas con anestesia espinal / Etilefrine in infusion as an alternative to cardiovascular stability in cesarean section with spinal anesthesia

La incidencia de la operación cesárea en nuestro país y en otros países del mundo ha ido en ascenso, por lo que el Anestesiólogo debe conocer las indicaciones y contraindicaciones de cada método anestésico. La anestesia regional es la indicación inicial y mandatoria salvo precisas condiciones que justifiquen llevar a una gestante a anestesia general cuya morbimortalidad es 16-17 veces mayor y las complicaciones más graves (dificultad o imposibilidad para intubación endotraqueal, ventilación fallida, neumonía por aspiración, trauma dental, náuseas y vómitos postoperatorios, lactancia demorada y sedación del recién nacido). La técnica regional permite óptimas condiciones quirúrgicas con hemodinamia estable, una madre despierta, facilita el alivio efectivo del dolor postoperatorio, por lo que en su mayoría se aplica anestesia subaracnoidea (espinal), sin embargo el efecto adverso más apreciado lo es la hipotensión arterial con una incidencia entre 40 y 100 por ciento, la cual puede representar un serio riesgo para la madre (náuseas, vómitos, inconsciencia, aspiración pulmonar, apnea o incluso paro cardíaco) y para el niño (daño en la perfusión placentaria que lleve a la hipoxia, acidosis fetal y daño neurológico). La frecuente ocurrencia y el rápido inicio de la hipotensión durante la anestesia espinal han estimulado a los Anestesiólogos a tratarla y prevenirla. Hoy se usan estrategias: métodos físicos (bandas elásticas y elevación de las piernas, lateralización del útero), líquidos intravenosos (cristaloides/coloides) y medicamentos simpaticomiméticos como Efedrina y Fenilefrina. Efedrina profiláctica disminuye la incidencia de hipotensión materna (de 85 a 5 por ciento) por vía intramuscular 25 ó 50mg inmediatamente luego de aplicada la anestesia, o vía endovenosa en bolos de 5 ó 10mg. También se ha utilizado Fenilefrina. En nuestro medio sólo disponemos de Etilefrina. En la gran mayoría de la práctica se usa como tratamiento más no como profilaxis de...

The incidence of cesarean section in our country and in other countries has been increasing, so that the anesthesiologist should know the indications and contraindications of each anesthetic method. Regional anesthesia is the initial indication and accurate except mandatory conditions that justify carrying a pregnant woman whose morbidity general anesthesia is 16 to 17 times larger and more serious complications (difficulty or inability to endotracheal intubation, failed ventilation, aspiration pneumonia, trauma dental, postoperative nausea and vomiting, delayed breastfeeding and sedation of the newborn). The regional technique allows optimal surgical conditions with stable hemodynamics, a mother awakens, facilitates effective postoperative pain relief, so that mostly applies subarachnoid (spinal), however the side effect is most appreciated as arterial hypotension an incidence between 40 and 100 per cent, which can be a serious risk to the mother (nausea, vomiting, unconsciousness, pulmonary aspiration, apnea or cardiac arrest) and child (damage to placental perfusion leading to hypoxia, acidosis fetal neurological damage). The frequent occurrence and the rapid onset of hypotension during spinal anesthesia have encouraged anesthesiologists to treat and prevent. Today we use strategies: physical (elastic bands and leg elevation, lateralization of the uterus), intravenous fluids (crystalloid / colloid) and sympathomimetic drugs such as Ephedrine and Phenylephrine. Prophylactic Ephedrine decreases the incidence of maternal hypotension (85 to 5 per cent) 25 or 50mg intramuscularly immediately after given anesthesia or intravenous bolus of 5 or 10mg. Phenylephrine has also been used. In our environment we have only Etilefrine. In the vast majority of the practice is not used as a prophylactic treatment of hypotension being therapeutic use conventional bolus objective whenever a drop in arterial pressure added to it symptoms like nausea and vomiting. Etilefrine is...

Vasopressores em bloqueios do neuroeixo para cesariana / Vasopressors in neuraxial anesthesia at cesarean sections

Justificativa e objetivos: Os fármacos vasopressores sempre apresentaram um lugar de destaque no controle da hipotensão arterial relacionada aos bloqueios do neuroeixo em anestesia obstétrica. Este artigo tem o objetivo de discutir os diversos fármacos utilizados na prática clínica e as inúmeras estratégias descritas na literatura para a prevenção e tratamento da hipotensão arterial pós-raquianestesia para cesariana. Conteúdo: Com a popularização da raquianestesia como técnica mais utilizada em anestesia para cesariana, os vasopressores tornaram-se pedra angular para a melhoria dos resultados maternos e fetais. Várias mudanças de paradigmas se apresentam nos dias atuais, destacando-se a segurança na utilização de fármacos alfa-agonistas, particularmente a fenilefrina. A efedrina já não tem sido mais considerada a primeira escolha em anestesia obstétrica, pois pode causar redução no pH fetal. Conclusões: A administração pro-filática e/ou terapêutica de agonistas alfa-adrenérgicos mostra-se segura e eficaz para o controle da hipotensão arterial pós-raquianestesia, otimizando os resultados maternos e fetais. Portanto, sugere-se revisão de conceitos.

Justification and objectives: vasopressor drugs have always been highlighted for the control of hypotension related to neuraxial blockade in obstetrical anesthesia. This article purpose is arguing the several drugs used in the clinical practice and the countless strategies described in the literature for the prevention and treatment of arterial hypotension after spinal anesthesia for caesarian section. Content: With the popularization of spinal anesthesia as the technique most used in anesthesia for caesarian section, vasopressors became the angular stone for the improvement of the maternal and fetal outcomes. Several changes of paradigms are introduced currently, highlighting the safe use of alpha-agonist drugs, particularly phenylephrine. Ephedrine has no longer been considered the unique first choice in obstetrical anesthesia, because it may cause reduction in fetal pH. Conclusions: The alpha adrenergic prophylactic and/or therapeutic administration proved to be a safe and effective option for the hypotension control after spinal anesthesia, optimizing the maternal and fetal outcomes. Therefore, that is the time for reviewing old concepts.

Estudo comparativo entre efedrina e etilefrina como vasopressor para correção da hipotensão arterial materna em cesarianas eletivas com raquianestesia / Ephedrine and etilefrine as vasopressor to correct maternal arterial hypotension during elective cesarean section under spinal anesthesia. Comparative study

JUSTIFICATIVA E OBJETIVOS: A efedrina é o vasopressor mais utilizado em obstetrícia e a etilefrina é muito usada em anestesia regional. O objetivo deste estudo foi comparar a efedrina com a etilefrina para correção de hipotensão arterial materna durante raquianestesia para cesariana eletiva. MÉTODO: Foram estudadas 120 gestantes divididas de forma aleatoria em dois grupos iguais. Todas receberam raquianestesia com bupivacaína, fentanil e morfina. Foi medida a pressão arterial não-invasiva e a freqüência cardíaca. Os recém-nascidos foram avaliados com o índice de Apgar. A incidência de hipotensão arterial, a quantidade de vasopressor necessária para correção e os efeitos adversos foram anotados. RESULTADOS: Ocorreu hipotensão arterial materna com freqüência nos dois grupos, sendo 68 por cento do grupo etilefrina e 63 por cento do grupo efedrina. Na maioria das gestantes foi corrigida com a primeira dose do vasopressor, sem diferença entre os grupos (66 por cento etilefrina, 58 por cento efedrina). A hipotensão arterial necessitou de duas ou mais doses de vasopressor para ser corrigida ou houve hipertensão reativa em poucas pacientes (24 por cento e 10 por cento do grupo etilefrina e 34 por cento e 8 por cento do grupo efedrina, respectivamente) sem diferença estatística significativa. Não houve diferença nos efeitos adversos e nos testes dos recém-nascidos. CONCLUSÕES: Com o método de administração empregado e com as doses de vasopressor selecionadas não houve diferença entre a efedrina e a etilefrina quando utilizadas para corrigir a hipotensão arterial materna em cesarianas com raquianestesia.

Tratamiento médico del priapismo con etilefrina / Medical treatment of priapism with etylephrine

Presentamos seis casos del priapismo, uno idiopático y cinco farmacológicos, tratados con inyección intracavernosa de etilefrina no diluida. En todos los casos se logró flacidez peneana casi inmediata y sin mayores efectos secundarios.

Derivative spectrophotometric determination of chlorpheniramine maleate in combination with etilefrine resinate or dextromethorphan hydrobromide

A simple, rapid and accurate method was represented for simultaneous determination of Chlorpheniramine maleate [I] in combination with etilefrine resinate [II] [Mixture A] or with dextromethorphane hydrobromide [III] [Mixture B]

Erección peneana sostenida y raquinestesia: detumescencia por inyección intracavernosa de etilefrina / Prolonged penile erection and rachianesthesia: detumescence by intracavernous etilefrine inyection

Se presentan 11 enfermos con erección peneana sostenida por raquianestesia con 20 mg de bupivacaine, que fueron tratados con 10 mg de etilefrina inyectados por vía intracavernosa. En 10 casos se obtuvo detumescencia total y un paciente en forma parcial. No se registraron complicaciones, solo un leve hematoma en el sitio de la inyección en 1 enfermo. Todos presentaron hipertensión arterial fácilmente controlable. Se analiza el mecanismo de la erección y la bibliografía

Triflupromazine , Methoxyflurane and Alcuronium for Pheochromocytoma Anesthesia / 대한마취과학회지

A 21 year-old female underwent resection of a pheochrocytoma under general anesthesia. The patient was treated with phenoxybenzamine for 5 days preoperatively and premedicated with triflupromazien, Librium, Seconal, pethidine, hydroxyzine and atropine in combination. Following indution of anesthesia with intravenous morphine and thiopental sodium, succinylchoine was administered intravenously and endotracheal intubation was performed. Anesthesia was maintained with nitrous oxide, oxygen and methoxyflurane, using a semiclosed carbon dioxide absorption circle system, and alcuronium was injection intermittently. Blood pressure during manipulation of tumor was increased up to 190/130 torr without arrhythmia and transiently dropped to 70/50 torr immediately after removal. Blood pressure was controlled by i.v. Hartmann's solution and whole blood with Solucortef and Effortil but not norepinephrine was needed. There was no marked tachycardis or arrhythmia during anesthesia, so a beta-adrenergic blocker(Inderal) was not used. The importance of preoperative preparation, premedication and selction of anesthetics is discussed.

The Effect of Effortil as a Prologing Agent for Spinal Anesthesia / 대한마취과학회지

Effortil is commonly used in this country as a vasopressor, replacing ephedrine. Various sbustances(i. e. ephedrine, neosynephrine, methedrin and epinephrine) have been added to spinal anesthetic agents in an attempt to prolong their action. We have used premixed 5% lidocaine with 5% dextrose solution as a main agent for spinal anesthesia for the past 6 years, and epinephrine has been used to prolong the spinal anesthesia. In this study, we have attempted to assess the possibility of the clinical use of Effortil in comparison with epinephrine for prologing the anesthetic effect of a spinal anesthetic agent. As a control group, 404 patients received premixed 5% lidocaine solution. In the 2nd group, 398 patients received 0. 2 mg of epinephrine added to the lidocaine solution. In the 3rd group, 337 patients received 3.0mg of Effortil added to the lidoeaine solution. The average duration of anesthetic effect was 97 minutes in the control group with lidocaine, 151 minutes in the 2nd group with epinephrine added to the lidocaine solution, and 113 minutes in the last group with Effortil added to the lidocaine solution. As a result of this study, we came to the conclusion that the Effortil may have a slight prolonging effect. However its effect is questionable as to its reliability for clinical use. Epinephrine is far better than Effortil and is more reliable and predictable for clinical use, as previously reported by other workers.

Clinical Study of Ten Cases of Continuous Spinal Anesthesia for Total Hip Replacement / 대한마취과학회지

This study was primarily undertaken to assess the value of continuous spinal anesthesia for total hip replacements (Charnley's low friction arthroplasty), which had been done under the Filtered Air Flow System for the prevention of wound contamination due to long term exposure. The results were as follows: 1. Preoperative diagnosis was in 4 cases hip joint tuberculosis,in 2 cases avascular necreosis, in 2 cases femur fracture, and in 2 cases osteoarthritis of the hip joint. 2. Average blood loss was 2, 800 ml for a one side operation and 5, 000 ml for a bilateral one. Overall average blood loss with continuous spinal anesthesia was 2, 600 ml and with general anesthesia was 1, 725 ml, and with amount of difference being 1. 175 ml more in the spinal anesthesia group (p<0. 025). 3. In 4 eases (40%) the hypotensive range was over 30% of the preoperative level, but recovery occurred soon after administration of Effortil. 4. Practically management of a patient with continuous spinal anesthesia is easier' thai with general anesthesia for total hip replacement, with fieeing of the anesthesio1ogist'a hands for better care of the patient during anesthesia.

Clinical Study for 20 Cases of Anesthesia for Total Replacement / 대한마취과학회지

We have experienced 20 cases of anesthesia for Total Hip Replacement(Charnleys Lov Frictinn Arthroplasty), which had been done under the Filtered Air Flow System for the prevention of wound contamination due to long term exposure. Preoperative diagnosis was, 7 cases of Hip Joint Tuberculosis, 6 cases of Femur Neck Fracture, 5 cases, of Osteoarthritis of Hip Joint, and 2 cases, of Avascular Necrosis. Average blood loss has 1500 ml for one side operation, and 2400 ml for bilateral one. In 12 cases, hypotensive response was occurred during the application of Acrylic bone cement to the medullary canal of femur, however in 4 cases, hypotensive responses was more prominentafter the application of Acrylic bone cement to the Acetabulum fossa and the rest of cases were no changes in blood pressure and pulse rate whatsoever. In two cases, hypotensive range was over 30%(in compare with preoperative one), but recovery was soon after administration of Effortil corticosteroids, volume expanders etc. There was no mortality.

Anesthesia for Total Hip Prosthesis / 대한마취과학회지

It has been generally known that hypotension may occur during total hip prosthesis with general anesthesia. However, The cause of hypotension is not well known. In these cases, of total hip prosthesis during general anesthesia, the following results were obstained. 1) during total hip prosthesis, blood pressure fell. 2) intravenous injection of effortil and dexamethasone improved the hypotension.

Study of Hypetension During Spinal Anesthesia for Cesarean Section / 대한마취과학회지

From September 1972 to August 1973, Ewha Womans University Hospital has performed 220 cases of Cesarean section under spinal anesthesia. Statistical analysis was done and the results can be summarized as follows. 1.Of the indications for primary Cesarean section, C.P.D., malpresentation and fetal distress comprised 89.4%. 2.The average values in distribution of hemoglobin and hematocrit were almost within normal limits. 3. The ages of pregnant women ranged from 20 to 44 years. The 21~30 age group of pregnant women who had Cesarean section was nearly double the 31~40 group. 4. 91.4% of all cases received scopolamine 0.3 mg by I.M. injection as premedication for anesthesia. In some cases, atropine sulfate 0.4 mg and pethidine hydrochloride 50mg were given. 5. Spinal puncture levels were from L2-L5 and 95.9% were conducted at L3-4 or L4-5. 6.The average number of punctures was 1.6. 7. The sensory levels of spinal anesthesia extended to from T1 to T8 and 95.5% were from T4 to T7. 8.The average time to initial drop of blood pressure was two and half minutes and its degree was 25 mm Hg on the average. 9.The average time to maximal drop of blood pressure was,16 minutes and it averaged 40 mm Hg of fall. 10. 40~80 mg of ephedrine was the most used vasopressor but in some cases, combined ephedrine hydrochloride 40mg and effortil 10mg were injected I.V. 11. Fluid amount given in the first five minutes was 180 ml on the average.12. In Cesarean section increase of blood pressure between before and after the delivery was 20 mmHg on the average. This may be considered due to use of uterine constrictor and vasopressor drugs. 13. The Apgar score average value was 8.5 and the percentage of scores above 8. 0 was 88.1% of the total cases. 14. The average value of induction delivery time was 20 minutes. 15. Diazepam 10 mg and pethidine hydrochloride 50 mg were given to 69.5% of total cases after the delivery. 16. A tendency towards a proportional relation between decreased blood pressure and anesthetic level was observed. However no specific relation was observed between decreased blood pressure and Apgar scores.

Clinical Observations on Effortil and Other Pressor Drugs / 대한마취과학회지

To 100 patients who underwent various operations under general anesthesia, Effortil and methoxamine were given in order to assess and to compare their effects on blood pressure and pulse rate. The drugs were administered intravenously in 6 to 10 mg doses when the systolic pressure fell to 80 mmHg. or lower during the operation. The results obtained are as follows: 1. Excellent pressor effect was obtained with Effortil in 84% of 50 patients while in 72% with methoxamine. 2. Both drugs were equally effectve in elevating both systolic and diastolic pressures. 3. The effect of Effortil on pulse rate was much less than that of methoxamine which moderately reduced the pulse rate, especially in the early phase. 4. No untoward effects of either Effortil or methoxamine were observed in this study.

Effects of Ethyladrianol of Urinary Flow in Normotensive Dog / 대한비뇨기과학회지

The mongrel dogs, anesthetized with pentobarbital sodium, were used as experimental animals. The effects of a single intravenous injection of ethyl adrianol. 0.5 mg per kg of body weight, on cardiovascular response and urinary flow were compared with those of epinephrine, 0.05 mg per kg of body weight and norepinephrine, 0.05 mg per kg of body weight. 1) The pressor effect induced with 0.5 mg of ethyl adrianol per kg of body weight was similar to that with equipressor doses, 0.05 mg, kg of epinephrine or norepinephrine. 2) The duration of the pressor action of ethyladrianol lasted at least one hour but only about 15minutes with equipressor dose of epinephrine or norepinephrine. 3) Ethyladrienol was responsible for the increase of the urinary volume, which phenomenon is assumed to be related of the renal-function and the durability of the reaction. 4) Ethyladrianol is considered to be one of the ideal drugs for the treatment of hypotensive shock.