Systemic mastocytosis is a life-threatening disease in which mast cell
mediator release can lead to general symptoms. The most common triggers
are stress and pain during labor and delivery. We report the management
of labor and delivery in a case with severe systemic mastocytosis by
epidural analgesia.
To examine the effects of nitrous oxide administration on atelectasis produced during general anesthesia evaluated by para-aortic line obliteration on postoperative plain chest X-ray films, 175ASA 1-2 patients undergoing elective major surgery (82 upper abdominal, 54 lower abdominal and 39head/neck operations) were evaluated. Subjects were allocated to Group G (with nitrous oxide) or Group A (no nitrous oxide) and postoperative chest X-ray film was studied within 1hr of emerging from anesthesia and para-aortic line obliteration ratio (PALO) was measured as division of obliterated by the total para-aortic line length. Upper abdominal surgery patients resulted in a significant increase of PALO than lower or head/neck surgery patients in both Group G and A. PALO of Group G was significantly higher than of Group A in upper abdominal surgery patients. However, there was no difference of PALO between two groups in lower abdominal and head/neck surgery patients. In conclusion, nitrous oxide results in minimal effects on PALO during lower abdominal and head/neck surgery, while it increases PALO during upper abdominal surgery.
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