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The action of spinal anesthesia on the perineum of parturient women
Audebert and Estienny: Parturient Women.
759
REVlEWS
AND
The
of Spinal Anesthesia d’ohst. et de Gyn&.
Bull.
Action d. Sot.
ABSTRACTS
on the Perineum of 18:
98, 1929.
It is generally conceded that spinal anesthesia exerts a softening a&on on the perineum. This action is deiinite but it is not constant. Occasionally it do@ not prevent extensive perineal lacerations and not infrequently an episiotomy must be performed to avoid injury. According to the authors, the action of lumbar anesthesia depends on the anatomic condition of the individual perineum. They report 30 observations in which they employed this type of anesthesia for performing breech extractions, forceps operations, and pubiotomy. In cases of forceps de.in cases of breech extraction the livery, spinal anesthesia gives good results, perineum is in great danger of being lacerated and spinal anesthesia is the physiologic complement of pubiotomy for which it permits nn extension of irldications. .J. 1'. (;REENHII,I,. Pistuadi: Forced and Accelerated Parturition ial Referace to the Method of Delmas.
in Arch.
Spinal Ostct.
Anesthesia (’ Ginec.
17:
With 408,
Spec19%).
The author after an aeeurate evaluation of the statistics of many authors and It is true that of his own personal experiences makes the following conclusions: in forced parturition or in attempts to accelerate labor and to hasten dilatation of the cervix, it is useful to protect the cervix from every reflex action, but to obtain this a spinal anesthesia is not necessary. A general narcosis will do just aa well when sufficiently deep. The author believes that spinal anesthesia may be given preference to general narcosis especially in cases of hypercinesia and when it is desirable to influence the uterine retraction and contraction. The author believes it would be better from now on, to speak of rachianesthesia and not, of the method of Delmas. SYDNEY S. Smcm~. JULIUS E. LACKNER. Metzger: Franc.
Some Observations de Gyn&. et d’obst.
of Dyntocia Labor 24: 14, 1929.
Under
Spinal
Anesthesia.
Rw.
Metzger has always felt that labor at a fixed hour was not a proper thing and his experience with this procedure in several cases of dystoeia has justified his opinion. Among five eases, one patient died of hemorrhage. The author admits that spinal anesthesia produces relaxation of the perineum but he maintains that the same is not true of the body of the uterus or the cervix. He has always held that dilatation of the cervix in a uterus which is at rest is impossible. Spinal anesthesia produces not a relaxation but a hypertonieity of the body of the uterus. If the uterus is normal and soft the cervix may be dilated rapidly but if the cervix is rigid, persistence in manual dilatation may result in rupture of the uterus. Hypertonicity of the uterus manifests itself when attempts at version or forceps delivery are made. Furthermore, when a cesarean section is performed under spinal anesthesia, the uterus is contracted and there is little bleeding. The author experienced difficulty in all five cases in which he tried the Delmas procedure. J. Tasaovatz, Gym%.
5. : Spinal et Obst. 24:
Anesthesia 350, 1929.
for
the
Low
Cesarean
Section.
P.
GREWHILL. Rev.
Frans.
do
At the Woman’s Clinic in Strasbourg, 56 low cervical cesarean sections formed under spinal anesthesia. In only two cases was there complete
were failure
perof
759
REVlEWS
AND
The
of Spinal Anesthesia d’ohst. et de Gyn&.
Bull.
Action d. Sot.
ABSTRACTS
on the Perineum of 18:
98, 1929.
It is generally conceded that spinal anesthesia exerts a softening a&on on the perineum. This action is deiinite but it is not constant. Occasionally it do@ not prevent extensive perineal lacerations and not infrequently an episiotomy must be performed to avoid injury. According to the authors, the action of lumbar anesthesia depends on the anatomic condition of the individual perineum. They report 30 observations in which they employed this type of anesthesia for performing breech extractions, forceps operations, and pubiotomy. In cases of forceps de.in cases of breech extraction the livery, spinal anesthesia gives good results, perineum is in great danger of being lacerated and spinal anesthesia is the physiologic complement of pubiotomy for which it permits nn extension of irldications. .J. 1'. (;REENHII,I,. Pistuadi: Forced and Accelerated Parturition ial Referace to the Method of Delmas.
in Arch.
Spinal Ostct.
Anesthesia (’ Ginec.
17:
With 408,
Spec19%).
The author after an aeeurate evaluation of the statistics of many authors and It is true that of his own personal experiences makes the following conclusions: in forced parturition or in attempts to accelerate labor and to hasten dilatation of the cervix, it is useful to protect the cervix from every reflex action, but to obtain this a spinal anesthesia is not necessary. A general narcosis will do just aa well when sufficiently deep. The author believes that spinal anesthesia may be given preference to general narcosis especially in cases of hypercinesia and when it is desirable to influence the uterine retraction and contraction. The author believes it would be better from now on, to speak of rachianesthesia and not, of the method of Delmas. SYDNEY S. Smcm~. JULIUS E. LACKNER. Metzger: Franc.
Some Observations de Gyn&. et d’obst.
of Dyntocia Labor 24: 14, 1929.
Under
Spinal
Anesthesia.
Rw.
Metzger has always felt that labor at a fixed hour was not a proper thing and his experience with this procedure in several cases of dystoeia has justified his opinion. Among five eases, one patient died of hemorrhage. The author admits that spinal anesthesia produces relaxation of the perineum but he maintains that the same is not true of the body of the uterus or the cervix. He has always held that dilatation of the cervix in a uterus which is at rest is impossible. Spinal anesthesia produces not a relaxation but a hypertonieity of the body of the uterus. If the uterus is normal and soft the cervix may be dilated rapidly but if the cervix is rigid, persistence in manual dilatation may result in rupture of the uterus. Hypertonicity of the uterus manifests itself when attempts at version or forceps delivery are made. Furthermore, when a cesarean section is performed under spinal anesthesia, the uterus is contracted and there is little bleeding. The author experienced difficulty in all five cases in which he tried the Delmas procedure. J. Tasaovatz, Gym%.
5. : Spinal et Obst. 24:
Anesthesia 350, 1929.
for
the
Low
Cesarean
Section.
P.
GREWHILL. Rev.
Frans.
do
At the Woman’s Clinic in Strasbourg, 56 low cervical cesarean sections formed under spinal anesthesia. In only two cases was there complete
were failure
perof