Does epidural analgesia influence the mode of delivery in primiparae managed actively? A preliminary study of 1250 women.

We studied 1250 primiparous women with a singleton pregnancy, gestational age at delivery of 37-42 weeks, with a single live fetus, vertex presentation whose first and second stages of labour were managed according to strict criteria for the active management of labour. 568 (45%) received epidural analgesia (bupivacaine 0.25%) during labour, and the other 682 (55%) received either Entonox, pethidine or no analgesia.

Influence of vitamin B12 status on the inactivation of methionine synthase by nitrous oxide.

We have studied the influence of maternal serum B12 concentration on the inactivation of placental methionine synthase activity by nitrous oxide in an obstetric population. This group was known to include patients with a wide range of B12 values. Over 70% of patients were given nitrous oxide either for analgesia during labour or for delivery by Caesarean section, for periods ranging from a few minutes to 11 h.

Somatosensory and auditory evoked responses recorded simultaneously: differential effects of nitrous oxide and isoflurane.

Auditory (AER) and somatosensory evoked responses (SSER) were recorded simultaneously in eight patients under anaesthesia before surgery. We studied the effects of equi-MAC end-expiratory concentrations of isoflurane (0.65-0.

Fulminant community acquired infections admitted to an intensive care unit.

Disease progression, support required, prognostic indicators and survival in hospital and after discharge were studied in 53 patients with community acquired infections who required admission to the intensive care unit from the Department of Infectious Diseases between January, 1985 and August, 1991. The median age was 37 years and over two-thirds of patients were previously fully fit; 38 per cent of patients required intensive care within 6 hours of admission with rapidly progressive disease. Both APACHE II scores and number of organ systems failed were good indicators of prognosis: mortality was 85 per cent in those with three or more organ failures and 86 per cent in those with APACHE II scores of > or = 25.

Early cortical auditory evoked response in anaesthesia: comparison of the effects of nitrous oxide and isoflurane.

Previous studies showing graded changes in the early cortical waves Pa and Nb of the auditory evoked response (AER) with increasing concentration of volatile anaesthetic agents demonstrated high amplitudes of these waves in the period immediately following induction of anaesthesia and tracheal intubation, when the patient breathed nitrous oxide alone. These high amplitude waves were not consistent with extrapolation of the data or observations of patients under steady-state nitrous oxide anaesthesia. In order to discriminate between effects in the period immediately following induction of anaesthesia and tracheal intubation, and effects caused by nitrous oxide alone, a randomized cross-over study was performed.