Four cases of extemporaneous evacuation of the uterus under spinal anesthesia

470 Olson

AMERICAN and

Van

Ess:

JOURNAL Pernocton

OF

OBSTETRICS

in Obstetrics,

AND

GYNE(!OLOGP

Wisconsin

M.

J. 32:

459,

1933.

l’crnocton is suitable for intr:r\enous administra,tion because of its solubility and because of the absence of delctcriuns effects eu mother and child. It has a distinct atlvautage over the other barbiturates because of the replacement of one hydrogen atom by the bromal radical. One cul)ic centimetar per 12?/, kilograms should serve only as the approximate dosagc. 111 t,Jre primipara morphine sulphate should precede the The solution may be given in the primipars when the cervix pcrnocton injection. Not more than 1 c.c. should is 3 or 4 cm. dilated and the pains are of good intensity. 1~2 given during an interval of L’ minutrs. Amnesia ranges from two to four hours. Sloughing at the site of injrctiou has not been noted. There was no maternal 01 fetal death in this series. The lendrm:y tn produce excitation was the only unsatis factory finding. J. ‘J’. ~ITIiEHSI'OOY I . Boucek Fetus Gy~rr.

and Renton: Experimenta and its Trmon Obst. 52: 884, 1931.

Studies of the Effect Through the Placenta of

of the

Amytal White

Upon the Rat, Surg.

Prom the experiment on 27 white rats the following conclusions arc made: (1) The amount of sodium amytal necessary to anesthetize a pregnant rat does not in any way interfere with the viability of the fetus; the fetus is not anesthetized and readily responds to gross stimulation. (2) Sodium amytal quickly passes from the maternal into the fetal circulation. (3 j In calculating the amount of sodium amytal necessary to anesthetize a pregnant animal, the weight of the fetuses must be subtracted from the weight of the mother. (4) The anesthetic value of sodium amytal may be enhanced when supplemented with small quantities of ether.

Kulka,

E.:

Lumbar

Aneothosia

in Obstetric

Operotiosrs,

Med.

WM.

0.

Klin.

29:

HENSKE.

354,

1933.

The value of lumbar anesthesia in obstetrics is still an unsettled question. Kulka has employed this form of anesthesia for the interruption of pregnancy up to the seventh month without any mishaps. From the fourth to the seventh months the operations consisted of vaginal cesarean sections. In a series of 37 patients there was only one death (due to pulmonary tuberculosis~). The author also used lumbar anesthesia in 9 cases of abdominal cesarean section. In eight cases the results were satisfactory except for one case of pneumonia. After the injection, the uterus contracted strongly so that the babies had to be extracted rapidly to avoid asphyxia. In one case, however, the patient collapsed three minutes after the injection. She recovered after artificial respiration and intracardial injection of adrenalin. J. Gannet:

Four

Anesthesia,

Caws

Bull.

of Extexr~pora~~~~ EvaouaUon Sot. cl’obst. et de gym%. 2: 124,

of the 1930.

Uterus

P.

GEEENHILL.

Under

Spinal

The author reports four cases where delivery was accomplished by means of manual dilatation of the cervix under spinal anesthesia. One patient was a multipara, the only case where dilatation was completely effected. According to’ Sonnet the results of this procedure are very inconstant, and it should be employed for strict indications only. Cases which are unsuitable are those where labor has been prolonged, where the uterus is contracted and the cervix is resistant. In such cases it is better to perform a vaginti hysterotomy. J. P. GREENHILL.