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British Journal of Anaesthesia, 1973, Vol. 45, No. 7 726-732
© 1973 The Board of Management and Trustees of the British Journal of Anaesthesia

other

ANAESTHESIA FOR SECTION: FURTHER REFINEMENTS OF A TECHNIQUE

J. S. CRAWFORD, F.F.A.R.C.S., MARILYN BURTON and P. DAVIES, M.SC., PH.D.

Birmingham Maternity Hospital
Department of Mathematical Statistics, University of Birmingham

Data derived from three groups of "clinically acceptable ideal patients" undergoing elective Caesarean section have been explored. All were tilted laterally during operation. The mothers who had been supine for at least half-an-hour before the start of the procedure developed a significant increase in metabolic acidosis during the period between induction of anaesthesia and delivery of the infant, a tendency not observed among mothers who had been tilted laterally for at least 30 minutes before induction. The infants of the latter group had slightly better Apgar-minus-colour scores than did those of the former group. The provision, for maintenance of anaesthesia until the time of delivery, of nitrous oxide 4 1./min, oxygen 8 1./min with 0.1% methoxyflurane in place of nitrous oxide 8 1./min and oxygen 4 1./min resulted in a highly significant improvement in the acid-base state and clinical condition of the infants at delivery, but was associated with a slight increase in the incidence of maternal awareness. The time elapsing between incision of the uterus and complete delivery of the infant appeared to be of some significance to the condition of the infants.


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