ANAESTHESIA FOR CAESAREAN SECTION: An Evaluation of a Method using Low Concentrations of Halothane and 50 per cent of Oxygen

Moir, Donald D.

doi:10.1093/bja/42.2.136

Cited by 117 publications

(37 citation statements)

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“…The use of 0.5 MAC of volatile in 50% nitrous oxide for Caesarean section stems from the work of Moir [10], who found that the addition of halothane 0.5% significantly reduced the risk of maternal awareness, compared with other general anaesthetic techniques in use at the time. However, the findings of a large cohort study by Lyons & MacDonald [11] suggested that using higher concentrations of volatiles could reduce this risk further.…”

Section: Discussionmentioning

confidence: 99%

A BIS‐guided study of sevoflurane requirements for adequate depth of anaesthesia in Caesarean section

Chin

Yeo

2004

Anaesthesia

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SummaryCaesarean section carries a high risk of awareness, especially in the period prior to neonatal delivery. We investigated the concentration of sevoflurane required to maintain bispectral index (BIS) < 60 until delivery occurred. We enrolled 23 parturients into an up-down sequential allocation study. The median effective end-tidal concentration (EC 50 ) of sevoflurane was defined as that which maintained BIS < 60 between skin incision and delivery in 50% of patients. This was calculated using Dixon and Massey's method. Receiver operating characteristic curve analysis was used to establish BIS response probability thresholds. The EC 50 for sevoflurane was 1.22% (1.08-1.33, 95% CI). The probability of maintaining BIS < 60 was < 55% at a concentration of < 1.1%; this increased to 80% at concentrations of 1.2-1.3%. We conclude that sevoflurane concentrations of at least 1.2-1.3% should be administered in uncomplicated Caesarean section, so as to minimise the risk of awareness and recall.

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Section: Discussionmentioning

confidence: 99%

A BIS‐guided study of sevoflurane requirements for adequate depth of anaesthesia in Caesarean section

Chin

Yeo

2004

Anaesthesia

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“…A historical example of this delay can be seen with reference to the use of volatile agents to prevent awareness during anaesthesia for Gauge of intravenous cannula Caesarean section. The use of volatile anaesthetic agents throughout the operation was recommended by Moir in 1970 [5]. However, the practice of turning off the volatile agent immediately after delivery continued to be common practice in many centres until 1985, as demonstrated by Lyons and Macdonald [6].…”

Section: Discussionmentioning

confidence: 99%

Local anaesthesia for cannulation

et al. 1995

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SummaryA questionnaire study was undertaken to assess the influence of recently published, simple and conclusive research on the practice of anaesthetists in four centres. The research had clearly demonstrated the benefit of subcutaneous infiltration of local anaesthetic in reducing the pain of intravenous cannulation. Of the 81 % who responded, 71 % were aware of the research; 43% of these anaesthetists had altered their clinical practice as a result of the research and 73% used local anaesthesia for cannulae of llgauge or less, compared with only 46% of those who were unaware of the research. Practice comparisons were made between centres andgrades of anaesthetist. Senior house ojicers were sign$cantly less likely to be aware of the research than othergrades. Anomalies were identijied between the apparent awareness of the research and routine practice agreeing with the study findings. The value of research and the incorporation of clinical findings into everyday practice is discussed.

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“…In 1969, Wilson and Turner unsurprisingly recorded that with the original 'Hamer Hodges' technique, 17% of patients had 'unpleasant recall' [22]. Shortly after this, Moir demonstrated that the incidence of awareness could be reduced to less than 1% by the addition of halothane [23]. With the exception of the evolution of…”

Section: Maternal Mortality: Moody Skiesmentioning

confidence: 99%

Unsettled weather and the end for thiopental? Obstetric general anaesthesia after the NAP5 and MBRRACE-UK reports

Lucas

Yentis

2015

Anaesthesia

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ANAESTHESIA FOR CAESAREAN SECTION: An Evaluation of a Method using Low Concentrations of Halothane and 50 per cent of Oxygen

Cited by 117 publications

References 0 publications

A BIS‐guided study of sevoflurane requirements for adequate depth of anaesthesia in Caesarean section

A BIS‐guided study of sevoflurane requirements for adequate depth of anaesthesia in Caesarean section

Local anaesthesia for cannulation

Unsettled weather and the end for thiopental? Obstetric general anaesthesia after the NAP5 and MBRRACE-UK reports

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