Abstract
General anesthesia was employed for 123 cesarean sections (including two twin deliveries) during a period of six years and two months from January 1958 through February 1964.
Two main anesthetic procedures were used. The first method used for 93 cesarean sections from 1958 through 1963 was as follows: the patients premedicated with oral barbiturates, intramuscularr pethidine and phenothiazine derivatives, were administered with cyclopropaneoxygen gas mixture through a mask during the early period of operations; following fetal deliveries, endotracheal tube was inserted with an aid of intravenous thiopenthal and succinyichaline, then anesthesia was maintained with nitrous oxide-oxygen gas mixture. The second method employedd for 30 sections from 1963, was consisted of: (1) premeditation with 0.5mg. of atropine sulfate; (2) intubation following i. v. thiopenthal (a sleep dose) and succinylcholine (40∼80mg.); (3) maintainance of anesthesia with nitrous oxide-oxygen gas mixture (if fetal distress presents, only pure oxygen was administered until ligation of the umbilical cord); and (4) additional i. v. thiopenthal and succinylcholine following neonatal deliveriesa No maternal deaths were associated with these procedures. Maternal blood pressure could be maintained relatively high during these procedures, especially in the second method.
Eight perinatal deaths (3.3%), including 3 intrauterine deaths prior to the operations, were observed in 95 babies delivered with the first method of anesthesia, while only one postnatal death (3.3%)was seen among 30 neonates with the second method. None of these deaths were primarily attributed to the anesthetic procedures. Asphyxia or retardation in the initial respiration was observed in 18 (18.9%) of the first group and in 6 (20.0%)of the second group. In 10 cases of the second group, fetal EKG were recorded through the abdominal leads, and found to demonstrate no remarkable changes during these anesthetic procedures.
