P Pu ur rp po os se e: : To review the effects of maternal anesthesia and analgesia on the fetus and newborn.M Me et th ho od ds s: : An on-line computerized search of Medline, Embase, and the Cochrane Collaboration via PubMed was conducted. English language articles were selected. The bibliographies of relevant articles and additional material from other published sources were retrieved and reviewed.P Pr ri in nc ci ip pa al l f fi in nd di in ng gs s: : No one test clearly separates the effects on the fetus/newborn, if any, of maternally administered medication during labour and delivery, or during surgery for non-obstetric indications. Supposition in this regard is limited in part by methodology previously used to study the transplacental passage of various drugs. This work needs to be repeated using a human model. Routine maternal supplemental oxygen administration is being questioned in light of research showing that free radical generation and oxidative stress are implicated as the underlying mechanisms in several neonatal conditions. Maternal hypotension is associated with neonatal acidemia and base excess correlates with neonatal outcome. Common postpartum analgesics transfer minimally into breast milk. Maternal or fetal surgery conducted during pregnancy necessitates modification of both anesthetic and surgical approaches. The key to resuscitation of the fetus is resuscitation of the mother: intra-uterine maneuvers, including perimortem Cesarean section, aim to reverse treatable causes of fetal asphyxia, restore fetal oxygenation, and correct fetal acidosis.C Co on nc cl lu us si io on ns s: : The well-being of the infant is a major criterion for evaluating the anesthetic management of pregnant women. Many tools exist to assist with this determination for the fetus, whereas few are available to evaluate the newborn. Méthode : Une recherche informatisée en ligne des bases Medline et Embase et du Centre de collaboration Cochrane via PubMed a été réalisée. Des articles de langue anglaise ont été sélectionnés. Les bibliographies d'articles pertinents et du matériel additionnel d'autres publications ont été retenus et passés en revue. Constatations principales : Aucun test ne sépare clairement les effets sur le foetus/nouveau-né, si effet il y a, des médicaments administrés à la mère pendant le travail et l'accouchement ou pendant une intervention chirurgicale non obstétricale. Les hypothèses possibles

The NACS had poor reliability both on simultaneous testing and in the test-retest situation when used to evaluate term, healthy neonates. The authors suggest that other measures need to be developed to evaluate the effect of intrapartum drug administration in the neonate. Health measurement scales should undergo rigorous assessment for reliability and validity before they are used in clinical practice or for research purposes.

P Pu ur rp po os se e: : To illustrate the anesthetic management of a term parturient with a large brain tumour scheduled for Cesarean section.C Cl li in ni ic ca al l f fe ea at tu ur re es s: : A 26-yr-old woman presented at 33 weeks gestation with a generalized grand mal seizure. Magnetic resonance imaging demonstrated a 5-cm multi-lobulated extra axial mass compatible with an epidermoid cyst, arising from the left temporal lobe associated with shift of the midline structures and compression of the brainstem. She remained stable neurologically until elective Cesarean section at 38 weeks. Immediately prior to induction of general anesthesia, the proposed incision site was infiltrated with lidocaine and the supraglottic structures anesthetized with bilateral superior laryngeal nerve blocks. Remifentanil, thiopentone sodium and succinylcholine were administered in a rapid sequence fashion following voluntary hyperventilation to an endtidal CO 2 of 28 mmHg. Anesthesia was maintained with desflurane in oxygen/air and an infusion of remifentanil. Postoperative pain control was achieved using a multi-modal approach which included intraperitoneal deposition of local anesthetic, im ketorolac and rectal acetaminophen prior to emergence followed by regular administration of naproxen and acetaminophen for 72 hr.

Purpose: This study was designed to determine if leaving a stylet in the left Bronch-Cath @ endobronchial tube (DLT) for the entire intubating procedure improves the accuracy of placement on the initial attempt, without introducing complications.Methods: Sixty ASA 1-3 patients were randomized to one of two groups. In Group I (n = 30) Accurate placement of double-lumen tubes (DLTs) is essential for one-lung ventilation. In the past, chest auscultation has been used to confirm placement of the CAN J ANAESTH 1996 / 43:3 / pp238-42