The Effects of Sevoflurane on Isolated Gravid Human Myometrium

Turner, Robert; Lambrost, M; Holmes, Courtney; Katz, Simon; Downs, C S; Collins, D.W.K.; Gatt, Stephen

doi:10.1177/0310057x0203000508

Cited by 39 publications

(18 citation statements)

References 38 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…However, we did not stratify non-elective CS to urgent and emergency CS, a limitation that might obscure the observations. The association with general anesthesia could also be explained by the use of volatile anesthetics in general anesthesia such as isoflurane, known as a powerful relaxant of uterine tone [14]. Moreover, general anesthesia increases blood pressure, and it is well established that higher blood pressure increases the chances for relaparotomy [2].…”

Section: Discussionmentioning

confidence: 99%

Relaparotomies after cesarean sections: risk factors, indications, and management

Shinar¹,

Hareuveni²,

Ben‐Tal³

et al. 2013

Journal of Perinatal Medicine

View full text Add to dashboard Cite

show abstract

Section: Discussionmentioning

confidence: 99%

Relaparotomies after cesarean sections: risk factors, indications, and management

Shinar¹,

Hareuveni²,

Ben‐Tal³

et al. 2013

Journal of Perinatal Medicine

View full text Add to dashboard Cite

show abstract

“…Currently, there is debate in the anesthetic literature about the preferred mode of anesthesia for women who require CH for abnormal placentation . The use of a neuraxial anesthetic technique offers potential advantages over general anesthesia for CH including a lower risk of complications associated with general anesthesia (such as failed or difficult intubation), high‐quality peri‐ and postoperative pain control, a reduced incidence of uterine atony, and reduced blood loss . However, using a general anesthetic approach as the primary anesthetic technique ensures that airway access is established and can optimize maternal oxygen delivery during periods of hypoperfusion secondary to major blood loss, which may also explain why general anesthesia was more common for women with PP in our study.…”

Section: Discussionmentioning

confidence: 99%

Perioperative and transfusion outcomes in women undergoing cesarean hysterectomy for abnormal placentation

et al. 2013

View full text Add to dashboard Cite

Background Women with placenta increta (PI) and placenta percreta (PP) are at high risk of obstetric hemorrhage, however the severity of hemorrhage and perioperative morbidity may differ according to the degree of placental invasion. We sought to compare blood component usage and perioperative morbidity between women with PI vs. PP undergoing CH (Cesarean hysterectomy). Study Design and Methods We identified 77 women who underwent CH for PI or PP from the NICHD MFMU Network Cesarean registry, which sourced data from 19 centers from 1999–2002. We examined demographic, obstetric and surgical data, and rates of transfusion and perioperative morbidity. We performed statistical tests for between-group analyses; P<0.05 as statistically significant. Results Rates of intraoperative or postoperative red blood cell (RBC) transfusion were similar between groups (PI=84% vs. PP=88%; P=0.7). We observed no between-group differences in rates of fresh frozen plasma (FFP) transfusion (intraoperative FFP: PI=30% vs. PP=41%; P=0.3; postoperative FFP: PI=28% vs. PP=18%; P=0.4) or platelet (PLT) transfusion (intraoperative PLTs: PI=14% vs. PP=29%; P=0.2; postoperative PLTs: PI=9% vs. PP=9%; P=1.0). Among the morbidities, a higher proportion of PP women underwent cystotomy (PI=14% vs. PP=38%, P=0.02) and postoperative mechanical ventilation (PI=14% vs. PP=35%; P=0.03). Conclusion Rates of intraoperative RBC, FFP and PLT transfusion are similar for PI and PP women, and perioperative outcomes are worse for PP women. We suggest the same mobilization transfusion medicine support for both groups, including blood-ordering (type and crossmatch for CH), and availability of emergency blood protocols including fibrinogen-containing preparations.

show abstract

“…Pre-exposure of sevoflurane would reduce the BIS index during the interval before delivery 8 . An end-tidal concentration of sevoflurane 1.2-1.5 vol% with 50% N 2 O would be required to maintain BIS values less than 60 34 , which is known to suppress uterine contraction by about only 30% 35 . Ueyama et al 36 reported that pregnant women does not have a lower minimal alveolar concentration (MAC) compared to non-pregnant women.…”

Section: Discussionmentioning

confidence: 99%

Comparison of electroencephalogram between propofol- and thiopental-induced anesthesia for awareness risk in pregnant women

Park

Kim

et al. 2020

Sci Rep

View full text Add to dashboard Cite

Some studies have suggested that EEG oscillations are related to altered states of consciousness produced by anesthetics 11-15. However, there is a lack of detailed characterization of oscillatory EEG activity regarding thiopental and propofol administration in pregnant women. Therefore, characterizing EEG spectral dynamics should help to establish the risk of awareness during general anesthesia. We aimed to investigate whether there are any differences in frontal brain oscillations between propofol-and thiopental-induced general anesthesia for cesarean section. Further, BIS and entropy analyses were also conducted to evaluate awareness risk in each group. Methods patient population. This study was approved by the Asan Medical Centre institutional review board (IRB number 2019-0737). The need for informed consent was waived, considering the retrospective nature of this analysis. The study conformed to the tenets of the Declaration of Helsinki. A retrospective analysis of EEG data recorded during elective cesarean section was conducted between September 2017 and May 2019. Our institute has traditionally used only thiopental (Pentothal sodium, JW Pharmaceutical, Seoul, Korea) for cesarean section, but there was a temporary supply interruption from November 2017 until March 2018. Propofol was then used as an alternative induction agent for cesarean section. After the re-supply of thiopental, agent selection was decided by the attending anesthesiologist. We identified all parturient women who received general anesthesia. Through chart review, parturients were divided into two groups according to the anesthetic agent: the thiopental and propofol groups. Inclusion criteria were between 20 and 44 years old, American Society of Anesthesiologist grade 1 or 2, and elective operation. Patients with the following conditions were excluded from the study: (1) cases where regional anesthesia was converted to general anesthesia; (2) exposure to sevoflurane before the induction of general anesthesia; (3) missing Vital Recorder data; (4) difficult airway management cases. Anesthetic management. Our institutional standardized anesthesia protocols were used for cesarean section. All parturient women received at least 3 min of pre-oxygenation using 100% oxygen, followed by RSI with cricoid pressure. Thiopental 5 mg/kg or propofol 2 mg/kg was administered, followed by succinylcholine 1.5 mg/kg to facilitate intubation. After disappearance of fasciculation and of the electromyography (EMG) activity bar on the BIS monitor, all patients were intubated with a 6.5-cuffed tracheal tube using a video-scope. After confirming successful intubation, rocuronium 0.5 mg/kg was immediately administered to achieve further muscle relaxation. Anesthesia was maintained with 50% nitrous oxide (N 2 O) in oxygen (6 L/min) and sevoflurane. The initially inspired concentration of sevoflurane was set at 2.0 vol% on the vaporizer until the end-tidal sevoflurane (Et-Sevo) reached 1.3 vol%. A skin incision was made after the anesthesiologist confirmed intubatio...

show abstract

The Effects of Sevoflurane on Isolated Gravid Human Myometrium

Cited by 39 publications

References 38 publications

Relaparotomies after cesarean sections: risk factors, indications, and management

Relaparotomies after cesarean sections: risk factors, indications, and management

Perioperative and transfusion outcomes in women undergoing cesarean hysterectomy for abnormal placentation

Comparison of electroencephalogram between propofol- and thiopental-induced anesthesia for awareness risk in pregnant women

Contact Info

Product

Resources

About