Summary
On the basis of experimental examinations it has been possible to show that halothane and cyclopropane of the inhalation anaesthetics have a protective action on the brain against anoxia. A similar but even better effect could be obtained by most intravenous anaesthetics, particularly thiopentone. If thiopentone was combined with 5 per cent carbon dioxide, this effect was doubled.
In obstetrical anaesthesia in 217 caesarean sections a barbiturate was used for induction. This lowered the Apgar score of the children, but probably increased the survival rate.
The conclusion to be drawn from these experimental and clinical studies would be that patients who have a possibility of being exposed to anoxia or are under influence of anoxia should preferably be anaesthetized with intravenous barbiturate anaesthetics and in this way be protected to some degree against the damaging influence of anoxia.
Résumé
II nous a été possible de démontrer expérimentalement que l’halothane et le cyclopropane parmi les agents anesthésiques par inhalation exercaient un effet protecteur sur le cerveau contre l’hypoxie. Avec les agents anesthésiques par voie endoveineuse, particulièrement le thiopentone, il est possible d’obtenir une effet semblable et même supérieur. Si le thiopentone est associé à l’inhalation de 5 pour cent de CO2, l’effet obtenu est doublé.
En anesthésie obstétricale, au cours de 217 césariennes, nous avons employé un barbiturique pour faire l’induction. Cette façon de faire a modifié l’évaluation d’Apgar pour les enfants en l’abaissant, mais fort probablement a augmenté le taux de survie.
Les conclusions à tirer de ces expériences et de ces études cliniques sont les suivantes: les malades qui seraient exposés à subir une hypoxie ou qui sont déjà sous l’effet d’une hypoxie devraient être anesthésiés de préférence par des barbituriques par voie endoveineuse; de cette façon, ils pourraient être assurés d’une certaine protection contre l’influence nuisible de l’hypoxie.
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Secher, O., Wilhjelm, B. The protective action of Anaesthetics against Hypoxia. Can. Anaes. Soc. J. 15, 423–440 (1968). https://doi.org/10.1007/BF03003728
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DOI: https://doi.org/10.1007/BF03003728