SOAP Newsletter Highlights - Society for Obstetric Anesthesia and ...

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Evolution 5. Krauer F: Maternal and umbilical cord plasma-cortisol concentrations related to different types of delivery. Arch Gynak 21S:343-3S0, 1973. 6. Maltau JM, Eielson OV, Stokke KT: Effect of stress during labor on the concentration of cortisol and estriol in maternal plasma. Am J Obstet Gynecol 134:681-684, 1979. 7. Levinson G, Shnider Sm, deLorimier AA, et al: Effects of maternal hyperventilation on uterine blood flow and fetl oxygenation ant acid-base status. Anesthesiology 40:340-347, 1974. 8. Miller FC, Petrie RH, Arce JJ, et al: Hyperventilation during labor. Am J Obstet Gynecol 120: 489- 495, 1974. 9. Shnider SM, Wright RG, Levinson G, et al: Uterine blood flow and plasma norepinephrine changes during maternal stress. Anesthesiology 50: 524-527, 1979. 10. Sangoul F, Fox GS, Houle GL. Effect of regional analgesia on maternal oxygen consumption during the first stage of labor. Am J Obstet Gynecol 121: 1080-1083, 1975. 11. Ueland K, Hansen JM: Maternal cardiovascular dynamics. III. Labor and delivery under local and caudal anesthesia. Am J Obstet Gynecol 103:8-18, 1968. 12. Moir DD, Willocks J: Management of inco-ordinate uterine action under continuous epidural analgesia. Br Med J III: 396-400, 1967. 13. Hollmen Al, Jouppila R, Jouppila P, et al: Effect of extradural analgesia using bupivacaine and 2chloroprocaine on intervillous blood flow during normal labour. Br J Anaest 54: 837-842, 1982. 14. Fulop-Miller R (1938) Triumph over pain. Translated by E&C Paul. The Literary Guild of America. New York. 15. Keys TE (1945) The History of Surgical Anesthesia. Henry Schuman, New York. 16. Snow J. (1858) On chloroform and other anesthetics: their action and administration. John Churchill, London (Reprinted by the American Society of Anesthesiologists, Chicago, 1959). 17. Keep NC (1847) The Letheon administered in a case of labor. Boston Med Surg J 36: 226. 18. Kninht N (1983) Pain and its relief. An exhibition at the National Museum of American History. Smithsonian Institution, Washington. 19. Channing W (1848) A Treatise on Etherization in Childbirth. Ticknor & Co. Boston. http://www.soap.org/newsletters/spring97/evolution.htm (4 of 9) [2/2/2005 4:22:55 PM]
Evolution 20. Simpson JY (1847) Account of a New Anaesthetic Agent as a Substitute for Supphuric Ether in Surgery and Midwifery. Sutherland and Know. Edinburgh (Reproduced by the Wood Library Museum of Anesthesiology, Park Ridge, 1976) 21. Marx GF, Katsnelson T (1993). The introduction of nitrous oxide analgesia into obstetrics. Obstet Gynecol 80:715-718 Part II: Regional Techniques The introduction of regional analgesia-anesthesia into obstetric practice took place at the turn of the century, one year after the German surgeon August Bier1 described six lower extremity operations rendered painless by means of "cocainization of the spinal cord". Impressed with these results, and even more so with those of the Parisian surgeon Tuffier2 whose 63 surgical procedures included lower abdominal operations, Oskar Kreis3, a young obstetrician at the Women's Clinic in Basel, Switzerland, began to employ the surgeons' technique in parturients. He injected 0.01 gram of cocaine intrathecally at the L4-5 interspace and observed complete pain relief within 5-10 minutes. He related his experiences with the first six women in a publication entitled "Regarding Medullary Narcosis in Parturients" and concluded as follows: "The impression gained from the medullary narcosis in parturients is remarkable. Loss of sensation to pain with maintained mobility and unclouded sensorium is most unusual." Like Bier and Tuffier, he observed no serious complications; vomiting and headache, however, occurred frequently. The first cesarean section under spinal block was performed in Paris by the obstetrician Doleris4 who spoke in "glowing terms of its usefulness in such cases because of the prompt and vigorous uterine contractions." In the US, S.R. Hopkins5 from Springfield, Illinois, reported in 1902 on the "superiority of spinal anesthesia over ether or chloroform in cases of cesarean section, because of the relaxed uterine muscles likely to be obtained with the patient anesthetized with either of the two latter methods." He injected "one-third grain of cocaine hydrochloride," dissolved in spinal fluid, and believed that this method accounted for the rarity of the usual post-anesthetic complaints of headache and vomiting. In 1905, novocaine (procaine) was introduced into clinical practice by the German surgeon Braun6 and rapidly replaced cocaine as the local anesthetic employed, not only for spinal block but for all existing and subsequent techniques. Then, in 1928, two American obstetricians, Pitkin and McCormack7, presented a method for "controllable" spinal block for labor and vaginal delivery. Rendering the anesthetic solution hyperbaric by using a 40% instead of 10% Novocaine solution with the addition of glucose, they produced a "limited" blockade allowing the parturient to repose in a semi-reclining position throughout delivery. This so-called "saddle" block completely anesthetized cervix, vagina, perineum and sphincters while leaving sensation of the uterus unimpaired. For many years thereafter, despite introduction of newer regional techniques, saddle block remained the anesthetic par excellence for vaginal births and regular spinal block for abdominal deliveries. http://www.soap.org/newsletters/spring97/evolution.htm (5 of 9) [2/2/2005 4:22:55 PM]
Page 1 and 2: SOAP Newsletter Highlights The Evol
Page 3 and 4: Evolution The Evolution of Obstetri
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Page 11 and 12: Evolution 15. Graffagnino P, Syler
Page 13 and 14: SOAP For Our Patients information!
Page 15 and 16: Anesthesia for Emergency Deliveries
Page 17 and 18: Physician Alert After reviewing the
Page 19 and 20: Physician Alert nurses and midwives
Page 21 and 22: The SOAP Box To the Editor: October
Page 23 and 24: The SOAP Box 2. Response to Letter
Page 25 and 26: Research Corner you would need to a
Page 27 and 28: New SOAP Members Oswaldo E. Lastres
Page 29 and 30: Calendar of Meetings & Announcement
Page 31: Calendar of Meetings & Announcement

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