The influence of preoxygenation in the supine (n = 10) versus the 45 degrees head-up (n = 10) position on the duration of apnea leading to a decrease in arterial oxygen saturation to 95%, as monitored by pulse oximetry, was investigated in 20 women undergoing elective cesarean section at term of pregnancy. The results were compared with those obtained in a control group of 20 nonpregnant women. In the supine position, the average time to desaturation to 95% was significantly shorter in the pregnant group (173 +/- 4.8 s [mean +/- SD]) than in the control group of nonpregnant women (243 +/- 7.4 s). Using the head-up position resulted in an increase in the desaturation time in the nonpregnant group (331 +/- 7.2 s) but had no significant effect in the pregnant group (156 +/- 2.8 s). We conclude that pregnant women desaturate their arterial blood of oxygen more rapidly than do nonpregnant women. Furthermore, the head-up position extends the duration of apnea that can take place before desaturation occurs in nonpregnant patients.
Ultrasound-guided femoral arterial cannulation in children when performed by anesthesia residents is superior to the palpation technique based on the reduction of the time taken for attempted cannulation and the number of attempts, and improvement in first attempt success.
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