[Hemodynamics in puerparas during subarachnoidal anesthesia with lidocaine].

Hemodynamic changes in response to subarachnoidal injection of 1.2-1.4 mg/kg of lidocaine at various concentrations were comparatively evaluated in 106 pregnant women aged 21 to 36 years (with 53 patients in each group). All the women underwent lumbar puncture at the level of L(II)-L(IV), 1.2-1.4 mg/kg of hyperbaric lidocaine solution being subarachnoidally administered. Groups 1 and 2 patients received 2 and 5% solution of the anesthetic, respectively. At the stages of anesthesia and surgery, the investigators examined central hemodynamics, recorded the duration of a complete segmental sensomotor block and the number of blocked segments (the extent of block). No significant differences were established at the time of development of a complete sensomotor block with the use of 2% (Group 1) and 5% (Group 2) lidocaine solutions. At the same time there were 16.8 +/- 0.6 and 11.9 +/- 0.5 blocked segments in Groups 1 and 2, respectively. In Group 1, severe hemodynamic disorders to be corrected were recorded in 30.2% of the women and in Group 2, subarachnoidal administration of the same doses of lidocaine did not cause any disorders.

[Brain injuries in relation to morphological structure of dura mater spinalis in pregnant women].

Morphological and histochemical investigations on dura mater spinalis of the lumbar site in 5 women of reproductive age dead from accidents and 5 women dead during deliveries due to hemorrhage were carried out. It was found that one of the etiological factors of head-aches after subarachnoid anesthesia was functional reduction of mechanic and supporting function of dura mater spinalis along with elasticity loss of fibrous tissue, edema and friability. The stable non-healing postpuncture defect of dura mater spinalis resulted in liquorrhea with subsequent development of the "liquorrhea hypotension" syndrome.