Horner's syndrome during epidural anaesthesia for elective caesarean section

Twenty ml of three per cent chloroprocaine solution was injected into the lumbar epidural space of a parturient for anaesthesia for elective caesarean section. Ten minutes after injection of the anaesthetic, the patient developed Horner's syndrome on the left side. The anaesthetic level was C7 on the affected side. Thirty minutes after the bolus dose of chloroprocaine the signs disappeared, at which time the patient received a reinforcing dose of 10 ml of chloroprocaine three per cent. The Horner's complex reappeared in eight minutes and persisted for 20 minutes. While Horner's syndrome is not uncommon in women in labour receiving lumbar epidural anaesthesia, it is virtually unknown in patients who are not in labour. The mechanism for the appearance of the syndrome in this case is unclear. The most likely explanation is that only a small amount of local anaesthetic was necessary to produce the syndrome and the subsequent bolus of anaesthetic followed pathways opened by the original dose, since a much smaller amount of anaesthetic was necessary to reproduce the syndrome.

Epidural anesthesia for cesarean section: a comparison of bupivacaine, chloroprocaine, and etidocaine

The authors studied three groups of patients undergoing elective cesarean section during lumbar epidural anesthesia with bupivacaine, 0.75 per cent (15 patients), chloroprocaine, 3 per cent (15 patients) or etidocaine, 1 per cent (ten patients). Excellent sensory and motor block were obtained with chloroprocaine and bupivacaine; sensory anesthesia was inadequate with etidocaine in most patients. Onset of anesthesia, induction--delivery interval, and stay in the recovery room were all longer with bupivacaine when compared with chloroprocaine. Fetal outcomes, as determined by Apgar scores, acid--base status and neurobehavioral testing, were equally good in all groups. At delivery, fetal/maternal concentration ratio of bupivacaine was 0.31 and that of etidocaine, 0.25. The umbilical artery--umbilical vein blood concentration difference for etidocaine was significantly higher than that for bupivacaine. Excellent clinical results were obtained using either bupivacaine, 0.75 per cent, alone, or chloroprocaine, 3 per cent- for induction and maintenance of anesthesia, supplemented with bupivacaine, 0.25 per cent, before removal of the catheter.

Separation of creatine from arginine in biological fluids by thin-layer chromatography

Creatine in biological fluids was estimated using a modified Sakaguchi procedure. Interference by arginine was eliminated by thin-layer chromatography.

Electron beam depth dose scaling by means of effective atomic number reconstructed from CT scans

A method is developed by which the computed tomography scans of a medium carried out at a number of diagnostic energies can be utilized to obtain the in situ "Effective Atomic Number" and "Effective Density". The electron depth dose curves in water when scaled by these factors estimate the actual electron depth dose distribution in that medium. It appears that the use of CT scans for electron beam treatment planning, in the management of cancer, is quite promising.

Effects of maternal position on epidural anesthesia for cesarean section, acid-base status, and bupivacaine concentrations at delivery

In 25 patients excellent clinical anesthesia for elective cesarean section was obtained with lumbar epidural block using an average dose of bupivacaine of 130 mg (18 ml of 0.75 per cent solution). Supplemental drugs were not needed. All infants had normal Apgar scores at delivery. Ten patients were kept in a 35--40 degree semi-sitting supine position during induction, while 15 patients were similarly semi-sitting but turned into the left lateral position. Maternal position did not affect the adequacy of the anesthesia or the clinical condition of the infants, but did alter acid-base state and bupivacaine concentrations in the infants. At delivery, the infants whose mothers had been supine had significantly lower pH values in umbilical cord blood than those whose mothers had been in the lateral position. Also, high concentrations of bupivacaine were found in the umbilical vein blood of infants whose mothers were supine.

Propranolol and parturition

Propranolol is a beta-adrenergic blocking drug with a wide spectrum of use and may diverse pharmacologic effects. This case report is an example of a parturient who was on a large dose of propranolol for idiopathic hypertrophic subaortic stenosis. The effects of this drug on pregnancy, labor, and above all, the fetus are discussed.

First fifteen amino acid residues in buffalo alpha S 1-casein from the N-terminal end

Conventional Edman degradation techniques with phenyl isothiocyanate and p-phenylazophenyl isothiocyanate were used to determine the first 15 amino-terminal amino acid residues in buffalo alpha S 1-casein. The results were compared to those of bovine alpha S 1-casein.

Acid-base status in diabetic mothers and their infants following general or spinal anesthesia for cesarean section

Acid-base status was studied in 30 diabetic mothers and their infants and in 30 healthy mothers and their babies after general or spinal anesthesia for cesarean section. A normal acid-base state was found for the diabetic subjects following general or spinal anesthesia. However, the infants of diabetic mothers given spinal anesthesia had an average pH of 7.20 and a base excess value of -5.67 mEq/l in umbilical-artery blood at delivery. These values were significantly lower than those observed in the infants of the other groups, where the average pH was between 7.28 and 7.30 and the base excess between -1.87 mEq/l and 1.00 mEq/l. These findings were significantly related to maternal diabetes and maternal hypotension.

Conversion by trypsin of nonsense suppressor-produced isozymes of triosephosphate isomerase to isozymes resembling the wild type

Nonsense suppressor genes caused the synthesis of new triosephosphate isomerase isozymes in Bacillus subtilis. Incubation with trypsin produced a large decrease in the apparent molecular weight of one such isozyme and simultaneously changed the electrophoretic behavior such that it resembled that of the wild-type enzyme.

Muscle pain following administration of suxamethonium to pregnant and non-pregnant patients undergoing laparoscopic tubal ligation

The frequency of muscle pain following suxamethonium was studied in 50 pregnant (8-13 weeks' gestation) and 100 non-pregnant women, undergoing laparoscopic tubal ligation. The incidence of muscle pain in the non-pregnant group was 42%, but only 20% in the pregnant women. The intensity of fasciculation was less in the pregnant patients. It appears that pregnancy protects the patient from suxamethonium pains, even during the first trimester.

Thin layer chromatographic estimation of available lysine in dried milk powder

A rapid method for the estimation of available lysine in dried milk powder has been developed. Samples were treated with 2,4,6-trinitrobenzene sulfonic acid and then hydrolyzed with 6N HCl. The hydrolysate was purified and subjected to ascending thin layer chromatography to isolate xi-trinitophenyl lysine in pure form. The color was read at 346 nm in a specitrophotometer.