Pre-oxygenation and apnoea in pregnancy: changes during labour and with obstetric morbidity in a computational simulation.

Abstract:

:Using the Nottingham Physiology Simulator, we investigated the effects on pre-oxygenation and apnoea during rapid sequence induction of labour, obesity, sepsis, pre-eclampsia, maternal haemorrhage and multiple pregnancy in term pregnancy. Pre-oxygenation with 100% oxygen was followed by simulated rapid sequence induction when end-tidal nitrogen tension was less than 1 kPa, and apnoea. Labour, morbid obesity and sepsis accelerated pre-oxygenation and de-oxygenation during apnoea. Fastest pre-oxygenation was in labour, with 95% of the maximum change in expired oxygen tension occurring in 47 s, compared to 97 s in a standard pregnant subject. The labouring subject with a body mass index of 50 kg x m(-2) demonstrated the fastest desaturation, the time taken to fall to an arterial saturation < 90% being 98 s, compared to 292 s in a standard pregnant subject. Pre-eclampsia prolonged pre-oxygenation and tolerance to apnoea. Maternal haemorrhage and multiple pregnancy had minor effects. Our results inform the risk-benefit comparison of the anaesthetic options for Caesarean section.

journal_name

Anaesthesia

journal_title

Anaesthesia

authors

McClelland SH,Bogod DG,Hardman JG

doi

10.1111/j.1365-2044.2008.05785.x

subject

Has Abstract

pub_date

2009-04-01 00:00:00

pages

371-7

issue

4

eissn

0003-2409

issn

1365-2044

pii

ANA5785

journal_volume

64

pub_type

杂志文章
  • Spontaneous movement after injection of propofol.

    abstract::Spontaneous movement following injection of propofol at induction was studied in 303 patients. Two hundred patients were Caucasians and 103 were Asians. In a pilot study carried out prior to the main study, 26% of the Asians moved at induction as compared with 6% of the Caucasians. The patients were studied in relatio...

    journal_title:Anaesthesia

    pub_type: 杂志文章

    doi:10.1111/j.1365-2044.1996.tb07850.x

    authors: Chan A,Nickoll E,Thornton C,Doré C,Newton DE

    更新日期:1996-07-01 00:00:00

  • Anaesthetic staffing in England and Wales.

    abstract::The numbers of anaesthetists and of surgeons in the English Health Regions and in Wales as at September 1978, are given in whole-time equivalents per 100,000 of population. All Regional figures are presented as percentages of the national average so that comparisons between Regions can be made. Marked inter-Regional d...

    journal_title:Anaesthesia

    pub_type: 杂志文章

    doi:10.1111/j.1365-2044.1980.tb05045.x

    authors: Rees LT

    更新日期:1980-11-01 00:00:00

  • Post-operative convulsions due to penicillin applied to the spinal theca.

    abstract::Two cases are described and discussed in which penicillin powder applied to the theca at the end of laminectomy caused delayed convulsions. ...

    journal_title:Anaesthesia

    pub_type: 杂志文章

    doi:10.1111/j.1365-2044.1975.tb00796.x

    authors: Bordbar A,Beheshti M

    更新日期:1975-01-01 00:00:00

  • Torsade de pointes ventricular tachycardia following coronary artery spasm during general anaesthesia.

    abstract::We present a patient who suffered two episodes of torsade de pointes ventricular tachycardia during general anaesthesia for abdominal surgery. The first occurred on suctioning of the tracheobronchial tree and the second while anaesthesia was light. Since ST segment elevation was in each case noted before the onset of ...

    journal_title:Anaesthesia

    pub_type: 杂志文章

    doi:10.1111/j.1365-2044.1996.tb12617.x

    authors: Mizutani K,Toyoda Y,Kubota H

    更新日期:1996-09-01 00:00:00

  • Diagnostic accuracy of anaesthesiologists' prediction of difficult airway management in daily clinical practice: a cohort study of 188 064 patients registered in the Danish Anaesthesia Database.

    abstract::Both the American Society of Anesthesiologists and the UK NAP4 project recommend that an unspecified pre-operative airway assessment be made. However, the choice of assessment is ultimately at the discretion of the individual anaesthesiologist. We retrieved a cohort of 188 064 cases from the Danish Anaesthesia Databas...

    journal_title:Anaesthesia

    pub_type: 杂志文章

    doi:10.1111/anae.12955

    authors: Nørskov AK,Rosenstock CV,Wetterslev J,Astrup G,Afshari A,Lundstrøm LH

    更新日期:2015-03-01 00:00:00

  • Conservation ethics and anaesthesia.

    abstract::The current attitude of conservators towards restoration is to preserve objects and materials in the condition as they are but without attempting to restore them 'as new'. Museum objects have generally ceased to serve their original utilitarian function but have become objects for study, information and inspiration. C...

    journal_title:Anaesthesia

    pub_type: 杂志文章

    doi:10.1046/j.1365-2044.2003.03402.x

    authors: Houghton IT

    更新日期:2003-10-01 00:00:00

  • Modification to the Sprotte spinal needle.

    abstract::The large lateral hole of the Sprotte needle is claimed to aid cerebrospinal fluid efflux during the performance of spinal anaesthesia. Using theoretical calculations and practical measurement we have shown that reducing the area of the lateral hole to that of the cross sectional area of the needle does not affect the...

    journal_title:Anaesthesia

    pub_type: 杂志文章

    doi:10.1111/j.1365-2044.1992.tb02277.x

    authors: Aglan MY,Stansby PK

    更新日期:1992-06-01 00:00:00

  • Respiratory injury in the burned patient. The role of flexible bronchoscopy.

    abstract::The purpose of the study was to investigate the role of flexible bronchoscopy in the management of patients admitted to a busy Regional burns unit, with particular reference to possible smoke inhalation injury. The basic procedure employed was that used in routine bronchoscopy for the diagnosis of bronchial carcinoma,...

    journal_title:Anaesthesia

    pub_type: 杂志文章

    doi:10.1111/j.1365-2044.1983.tb10370.x

    authors: Clark CJ,Reid WH,Telfer AB,Campbell D

    更新日期:1983-01-01 00:00:00

  • Subarachnoid spread of epidural local anaesthetic following dural puncture.

    abstract::A case is described of an extensive block and hypotension which occurred after inadvertent dural puncture and subsequent epidural injection of bupivacaine. The subarachnoid spread of solution from the extradural space was confirmed radiologically. ...

    journal_title:Anaesthesia

    pub_type: 杂志文章

    doi:10.1111/j.1365-2044.1988.tb04155.x

    authors: Leach A,Smith GB

    更新日期:1988-08-01 00:00:00

  • Effect of single-dose omeprazole on intragastric acidity and volume during obstetric anaesthesia.

    abstract::Various antacid or antisecretory agents are used to reduce the risk to patients of aspiration of gastric contents during general anaesthesia and a trial of the gastric proton pump inhibitor, omeprazole, is reported here. Twenty women admitted for elective Caesarean section under general anaesthesia received a single 8...

    journal_title:Anaesthesia

    pub_type: 杂志文章

    doi:10.1111/j.1365-2044.1989.tb11441.x

    authors: Moore J,Flynn RJ,Sampaio M,Wilson CM,Gillon KR

    更新日期:1989-07-01 00:00:00

  • Speed of injection and spread of bupivacaine in the epidural space.

    abstract::Speed of injection of bupivacaine was assessed in 73 women who received epidural analgesia in labour. Rapid injection was shown to produce quicker onset of epidural block and more reliable perineal anaesthesia than slow injection, but there was no difference in the final extent of the block. ...

    journal_title:Anaesthesia

    pub_type: 杂志文章

    doi:10.1111/j.1365-2044.1987.tb02990.x

    authors: Griffiths RB,Horton WA,Jones IG,Blake D

    更新日期:1987-02-01 00:00:00

  • The oculo-emetic reflex. A rationalisation of postophthalmic anaesthesia vomiting.

    abstract::Data related to the incidence of postoperative vomiting were collected during prospective studies on 607 ophthalmic surgical patients of all ages who underwent halothane anaesthesia with spontaneous ventilation. Analysis of data in respect of age, sex and surgical site variables, and time of onset of vomiting, identif...

    journal_title:Anaesthesia

    pub_type: 杂志文章

    doi:10.1111/j.1365-2044.1989.tb11157.x

    authors: van den Berg AA,Lambourne A,Clyburn PA

    更新日期:1989-02-01 00:00:00

  • Attitudes of patients and anaesthetists to informed consent for specialist airway techniques.

    abstract::We investigated the attitudes of 96 patients and 163 anaesthetists to the need for obtaining informed consent before specialist airway techniques. Participants were asked to score six questions using a numerical scale, as to whether they thought consent was necessary before specific procedures, particularly in relatio...

    journal_title:Anaesthesia

    pub_type: 杂志文章,多中心研究

    doi:10.1046/j.1365-2044.2002.02749.x

    authors: Bray JK,Yentis SM

    更新日期:2002-10-01 00:00:00

  • Patient-controlled analgesia--the need for caution. A case report and review of adverse incidents.

    abstract::Respiratory depression and oversedation occurred during the administration of patient-controlled analgesia because of a broken syringe barrel. Possible complications in the use of patient-controlled analgesia are reviewed. These may be because of prescription or provision errors, patient factors or equipment problems....

    journal_title:Anaesthesia

    pub_type: 杂志文章,评审

    doi:10.1111/j.1365-2044.1988.tb05753.x

    authors: Thomas DW,Owen H

    更新日期:1988-09-01 00:00:00

  • Torsade de pointes and long QT syndrome following major blood transfusion.

    abstract::We report a rare complication following transfusion of a large volume of blood in an adult patient. An electrophysiological disturbance of the cardiac cycle with prolongation of the QT interval developed, which was followed by recurrent episodes of torsade de pointes, a unique form of ventricular tachycardia. The most...

    journal_title:Anaesthesia

    pub_type: 杂志文章

    doi:10.1111/j.1365-2044.1992.tb02008.x

    authors: Kulkarni P,Bhattacharya S,Petros AJ

    更新日期:1992-02-01 00:00:00

  • Regional anaesthesia in day-stay and short-stay surgery.

    abstract::The goals for ambulatory surgery are rapid recovery with minimal side effects, adequate postoperative pain control, rapid patient discharge and overall cost containment. The addition of regional anaesthetic techniques has been shown to decrease nausea, postoperative pain scores and the need for post-anaesthesia care u...

    journal_title:Anaesthesia

    pub_type: 杂志文章,评审

    doi:10.1111/j.1365-2044.2009.06204.x

    authors: Kopp SL,Horlocker TT

    更新日期:2010-04-01 00:00:00

  • Severe hypotension due to intramyometrial injection of prostaglandin E2.

    abstract::Treatment of postpartum haemorrhage because of uterine atony with intramyometrial prostaglandin E2 1 mg, in an anaesthetised patient resulted in life-threatening hypotension. Anaesthetists should be aware of the potential cardiovascular side effects of prostaglandins. ...

    journal_title:Anaesthesia

    pub_type: 杂志文章

    doi:10.1111/j.1365-2044.1990.tb14569.x

    authors: Kilpatrick AW,Thorburn J

    更新日期:1990-10-01 00:00:00

  • Immediate care of cardiac emergencies.

    abstract::The emergency treatment of serious disorders of cardiac rhythm, left heart failure, cardiogenic shock, and cyanotic attacks is discussed. The article is intended for medical practitioners without special cardiological experience. ...

    journal_title:Anaesthesia

    pub_type: 杂志文章

    doi:10.1111/j.1365-2044.1976.tb11866.x

    authors: Chamberlain DA,Williams JH

    更新日期:1976-07-01 00:00:00

  • Psychological assessment of ICU survivors: a comparison between the Hospital Anxiety and Depression scale and the Depression, Anxiety and Stress scale.

    abstract::Recovery from a critical illness can be delayed by persistent anxiety and depression. To identify such patients, a new self-report questionnaire (the Depression, Anxiety and Stress scale, DASS) was used alongside an established instrument (the Hospital Anxiety and Depression scale, HADS) in those who had spent a minim...

    journal_title:Anaesthesia

    pub_type: 杂志文章

    doi:10.1111/j.1365-2044.2006.04948.x

    authors: Sukantarat KT,Williamson RC,Brett SJ

    更新日期:2007-03-01 00:00:00

  • Handover of responsibility for the anaesthetised patient - opinion and practice.

    abstract::Anaesthesia is a critical and complex process that extends from the pre-operative assessment through to the postoperative management of patients. Handover of responsibility for logistical as opposed to patient-orientated reasons may compromise that process of care. If such handover becomes inevitable with shift-based ...

    journal_title:Anaesthesia

    pub_type: 杂志文章

    doi:10.1111/j.1365-2044.2004.03760.x

    authors: Horn J,Bell MD,Moss E

    更新日期:2004-07-01 00:00:00

  • Use of acronyms in anaesthetic and associated investigations: appropriate or unnecessary? - the UOAIAAAIAOU Study.

    abstract::We examined the prevalence of novel acronyms in the titles of anaesthetic and related studies and the response of anaesthetists to them. We separately analysed trainee-led research projects in the UK supported by the Research and Audit Federation of Trainees (RAFT), and a 10-year cohort of papers identified using the ...

    journal_title:Anaesthesia

    pub_type: 杂志文章

    doi:10.1111/anae.14450

    authors: Weale J,Soysa R,Yentis SM

    更新日期:2018-12-01 00:00:00

  • The haemodynamic effects of intravenous induction. Comparison of the effects of thiopentone and propofol.

    abstract::The haemodynamic changes following induction of anaesthesia with equipotent doses of propofol and thiopentone have been compared. Propofol caused a significant fall in arterial blood pressure and total peripheral resistance, with a slight fall in cardiac output. There were no changes in heart rate. Apart from an initi...

    journal_title:Anaesthesia

    pub_type: 杂志文章

    doi:10.1111/j.1365-2044.1985.tb10996.x

    authors: Grounds RM,Twigley AJ,Carli F,Whitwam JG,Morgan M

    更新日期:1985-08-01 00:00:00

  • Evaluation of an insulated Tuohy needle system for the placement of interscalene brachial plexus catheters.

    abstract::Major shoulder surgery can be extremely painful. Interscalene brachial plexus catheters provide excellent postoperative analgesia but are technically difficult to place. A new insulated Tuohy needle system for plexus catheterisation is now available. This prospective study examined its ease of use and the postoperativ...

    journal_title:Anaesthesia

    pub_type: 杂志文章

    doi:10.1046/j.1365-2044.2003.03184.x

    authors: Denny NM,Barber N,Sildown DJ

    更新日期:2003-06-01 00:00:00

  • The emergency management of diabetes mellitus.

    abstract::Some of the acute metabolic derangements of unstable diabetes have been discussed. The management of patients undergoing surgical operations has also been considered. No problems are usually encountered in diabetic patients treated with diet alone or with oral hypoglycaemic compounds, although chlorpropamide may need ...

    journal_title:Anaesthesia

    pub_type: 杂志文章

    doi:10.1111/j.1365-2044.1975.tb00900.x

    authors: Maw DS

    更新日期:1975-07-01 00:00:00

  • Observations on deliberate dural puncture with a Tuohy needle: pressure measurements.

    abstract::Pressure recordings were made during passage of a Tuohy needle from the interspinous ligament to the subarachnoid space for lumbar drain insertion. Epidural space pressures were always positive. Negative pressures were seen only at the moment of entry into the subarachnoid space. These were artefactual and were caused...

    journal_title:Anaesthesia

    pub_type: 杂志文章

    doi:10.1111/j.1365-2044.1991.tb09765.x

    authors: Telford RJ,Hollway TE

    更新日期:1991-09-01 00:00:00

  • Career opportunities in anaesthesia for doctors with domestic commitments. A report of a working party.

    abstract::The position of doctors with domestic commitments (DDCs) at present training in the specialty of anaesthesia in the British National Health Service is considered and proposals are made for their future employment in career grades. ...

    journal_title:Anaesthesia

    pub_type: 杂志文章

    doi:10.1111/j.1365-2044.1981.tb08678.x

    authors: Edmonds-Seal J,McNeilly RH

    更新日期:1981-11-01 00:00:00

  • Assessing the position of the tracheal tube. The reliability of different methods.

    abstract::Various methods have been developed to confirm proper intubation of the trachea. This blind, randomised study evaluates some of these quantitatively and qualitatively. Forty patients had both their trachea and oesophagus intubated. A procedure that included auscultation of the upper abdomen and lungs was 100% reliable...

    journal_title:Anaesthesia

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1111/j.1365-2044.1989.tb09203.x

    authors: Andersen KH,Hald A

    更新日期:1989-12-01 00:00:00

  • Some observations of levels of plasma cholinesterase activity within an obstetric population.

    abstract::An account of plasma cholinesterase activity in samples of maternal and cord blood is presented. It is confirmed that plasma exchange markedly reduces the level of activity in maternal blood, and that the level is further reduced during the first 3-4 postnatal days. A particularly marked decrease was found in those ca...

    journal_title:Anaesthesia

    pub_type: 杂志文章

    doi:10.1111/j.1365-2044.1988.tb05423.x

    authors: Whittaker M,Crawford JS,Lewis M

    更新日期:1988-01-01 00:00:00

  • Evaluation of the disposable Vital View laryngoscope apparatus.

    abstract::The Vital View laryngoscope (Vital Signs, NJ, USA) consists of a plastic disposable blade containing a fibrelight and a non-disposable handle; there is therefore no need to sterilise the blade and no concern about disintegration of the fibrelight. In a random cross-over design, we compared the Vital View laryngoscope ...

    journal_title:Anaesthesia

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1046/j.1365-2044.2001.01906.x

    authors: Asai T,Uchiyama Y,Yamamoto K,Johmura S,Shingu K

    更新日期:2001-04-01 00:00:00

  • Multiple organ failure and severe bone marrow dysfunction in two 18 year-old Caucasian patients: Epstein-Barr virus and the haemophagocytic syndrome.

    abstract::Haemophagocytic lymphohistiocytosis secondary to viral infection is an unusual but well recognised cause of bone marrow dysfunction and multiple organ failure in young patients. Two 18 year-old patients were admitted to a tertiary liver unit with features of acute liver failure, cardio-respiratory collapse and pancyto...

    journal_title:Anaesthesia

    pub_type: 杂志文章

    doi:10.1111/j.1365-2044.2008.05584.x

    authors: Berry PA,Bernal W,Pagliuca A,Sizer E,Salisbury JR,Wendon JA,Auzinger G

    更新日期:2008-11-01 00:00:00