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Kirchner, W.: Intravenous Narcosis in Obstetrics
1060
AMERICAN JOCRXAL OF' OBSTETRICS AN D GYC\TECOLOGY
The forceps above described , combinell with the axis traction attachment, satisfactorily fulfills every need for traction, at the same time a~suring the greatest possible margin of safety. When, howevt'r, it is neeessary to apply forcepR to an aftercoming head the Luikart-Kjelland forceps2 is preferable because, like the Piper forceps, it has no pelvie enrve, and in addition posBesses the safety factor of the closed fenestra.
Fig. 3.-Luikart forceps and axis traction attachment. Note standard pelvic and cephalic curves of blades, closed fenestra, sliding lock, modified left ha ndle, axis traction, showing !'implicity of attachment a nd direction pointer. Hence, these two forceps (the type describeu in this paper and the LuikartKjelland type) and the axis traction attachment should completely fill an obstetrician's needs for forceps, at the same time offering the greatest margin of safety in each operation. I wish to acknowledge with thanks assistance given by J. Sklar and Company, Long Island City, N. Y., by Dr. Ra lph Reese of Chicago and Dr. Maurice E. Grier, of Omaha, for suggestions in regard to the handle modification and by Dr. Frank Murphy of Omaha for assistance in the photography.
REFERENCES
(1) Bill, A. H.: Am. J. Obst. Gynec. 9: 606, 1925. 34: 686, 1937.
Kirchner, W.:
(3) LJbikart, Ralph: Ibid.
Intravenous Narcosis in Obstetrics, Med. Klin. 35: 1342, 1939.
Kirchner emphasizes that the administration of an intravenous narcotic is as much of a hardship on a pregnant woman as any other anesthetic. For a long time he has used the typical morphin,e-scopolamine twilight sleep to which he has added pernocton and also dilaudid. ·when evipan was introduced as an intravenous anesthetic he began to make use of it. This drug proved to be helpful for obstetric operations except cesarean section, and version and extraction. Evipan proved useful also in eclampsia regardlei'ffi of whether th.e convulsions occurred during pregnancy, labor or after delivery. It is generally believed that evipan has no deleterious effect on the hahy although some authors believe the babies are born asphyxiated and remain drowsy for a few days after birth. Evipan has no effec.t on uterin e con traction~ during labor. However, since this drug may have a bad effect on the uterus in the third stage, it is recommended that small doses of pituitary ex tract be given with this drug. J. P. GREENIULL
AMERICAN JOCRXAL OF' OBSTETRICS AN D GYC\TECOLOGY
The forceps above described , combinell with the axis traction attachment, satisfactorily fulfills every need for traction, at the same time a~suring the greatest possible margin of safety. When, howevt'r, it is neeessary to apply forcepR to an aftercoming head the Luikart-Kjelland forceps2 is preferable because, like the Piper forceps, it has no pelvie enrve, and in addition posBesses the safety factor of the closed fenestra.
Fig. 3.-Luikart forceps and axis traction attachment. Note standard pelvic and cephalic curves of blades, closed fenestra, sliding lock, modified left ha ndle, axis traction, showing !'implicity of attachment a nd direction pointer. Hence, these two forceps (the type describeu in this paper and the LuikartKjelland type) and the axis traction attachment should completely fill an obstetrician's needs for forceps, at the same time offering the greatest margin of safety in each operation. I wish to acknowledge with thanks assistance given by J. Sklar and Company, Long Island City, N. Y., by Dr. Ra lph Reese of Chicago and Dr. Maurice E. Grier, of Omaha, for suggestions in regard to the handle modification and by Dr. Frank Murphy of Omaha for assistance in the photography.
REFERENCES
(1) Bill, A. H.: Am. J. Obst. Gynec. 9: 606, 1925. 34: 686, 1937.
Kirchner, W.:
(3) LJbikart, Ralph: Ibid.
Intravenous Narcosis in Obstetrics, Med. Klin. 35: 1342, 1939.
Kirchner emphasizes that the administration of an intravenous narcotic is as much of a hardship on a pregnant woman as any other anesthetic. For a long time he has used the typical morphin,e-scopolamine twilight sleep to which he has added pernocton and also dilaudid. ·when evipan was introduced as an intravenous anesthetic he began to make use of it. This drug proved to be helpful for obstetric operations except cesarean section, and version and extraction. Evipan proved useful also in eclampsia regardlei'ffi of whether th.e convulsions occurred during pregnancy, labor or after delivery. It is generally believed that evipan has no deleterious effect on the hahy although some authors believe the babies are born asphyxiated and remain drowsy for a few days after birth. Evipan has no effec.t on uterin e con traction~ during labor. However, since this drug may have a bad effect on the uterus in the third stage, it is recommended that small doses of pituitary ex tract be given with this drug. J. P. GREENIULL