The Treatment of Eclampsia by Means of Regional Nerve Block

Whitacre, Frank E.; Hingson, Robert A.; Turner, Henry B.

doi:10.1097/00006254-194906000-00013

Obstetrical & Gynecological Survey

1949

DOI: 10.1097/00006254-194906000-00013

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The Treatment of Eclampsia by Means of Regional Nerve Block

Frank E. Whitacre

Robert A. Hingson

Henry B. Turner

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1950

1954

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Cited by 2 publications

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“…This led to the belief that in normal pregnancy the blood pressure is maintained mainly by neurogenic impulses, while in toxemic pregnancy the blood pressure is supported principally by humoral mechanisms. It was also suggested that a certain degree of venous pooling might be a contributing factor in the blood pressure fall following autonomic blockade with TEAC.Since recent reports (5)(6)(7)(8) extensive blockade achieved with higher concentrations of anesthetic solutions. …”

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confidence: 99%

“…Since recent reports (5)(6)(7)(8) extensive blockade achieved with higher concentrations of anesthetic solutions.…”

mentioning

confidence: 99%

“…Since recent reports (5)(6)(7)(8) on the treatment of toxemia of pregnancy with spinal anesthesia have indicated that a marked hypotension is usually observed, why then would the effect of autonomic blockade with TEAC and spinal anesthesia be different on toxemic hypertension? This question gained more strength in the face of the conflicting opinions regarding the extent of the blocking action of TEAC as compared to that of spinal anesthesia or paravertebral block (3,(9)(10)(11)(12)(13) …”

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confidence: 99%

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Studies on Autonomic Blockade. I. Comparison Between the Effects of Tetraethylammonium Chloride (Teac) and High Selective Spinal Anesthesia on Blood Pressure of Normal and Toxemic Pregnancy 1

Assali¹,

Prystowsky²

1950

J. Clin. Invest.

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Previous studies have indicated that autonomic blockade with tetraethylammonium chloride produces different effects in normal term pregnancy and in toxemia of pregnancy (1-4). In the former, a fall in the blood pressure to very low levels occurs, while in the latter the blood pressure fall is negligible. This led to the belief that in normal pregnancy the blood pressure is maintained mainly by neurogenic impulses, while in toxemic pregnancy the blood pressure is supported principally by humoral mechanisms. It was also suggested that a certain degree of venous pooling might be a contributing factor in the blood pressure fall following autonomic blockade with TEAC.Since recent reports (5)(6)(7)(8) extensive blockade achieved with higher concentrations of anesthetic solutions. MATERIALThe material consisted of 12 normal term pregnancies; 15 toxemic pregnancies (two cases with convulsive eclampsia, 11 with severe pre-eclampsia and two cases with pre-eclampsia superimposed on pre-existing essential hypertension); and five healthy, young normotensive non-pregnant females (medical students and paid volunteers). A total of 32 patients submitted to 66 high spinal and 73 TEAC tests (some of the patients had more than one test with both spinal and TEAC). The age of the patients ranged from 15 to 40 years, an average of 24.5 years. The diagnosis of pre-eclampsia and eclampsia was based on the same criteria as outlined by Brust, Assali, and Ferris (1). Of the 12 normal pregnant females, 10 patients were studied in the prepartum and postpartum periods; two refused the postpartum test. Among the toxemic group, 12 were studied in the prepartum and postpartum periods; three refused the postpartum test.In all normal pregnant patients the prepartum tests were performed between 33 and 40 weeks' gestation. The postpartum assays were done 36 to 48 hours after delivery. Toxemic patients were studied prepartum at the height of toxemic symptoms; in the postpartum period the study was performed when all signs of toxemia had subsided (only one patient had her postpartum test while she was still toxic). METHODAll of the patients were on the ward, without any medication, for at least 24 hours prior to the test. None was in labor. Both TEAC and spinal anesthesia studies were conducted with the patient lying in the supine position on an operating table which was maintained always in the horizontal position. Tilting of the table to obtain changes in the anesthetic level was not done because the anesthetic solution used was practically isobaric and its simple diffusion and dispersion in the spinal fluids were sufficient to obtain the desired level. The blood pressure was recorded by a mercury sphygmomanometer attached to one arm and maintained at heart level. Pulse rate was recorded at either radial or carotid artery.1354

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confidence: 99%

“…Since recent reports (5)(6)(7)(8) extensive blockade achieved with higher concentrations of anesthetic solutions.…”

mentioning

confidence: 99%

mentioning

confidence: 99%

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Studies on Autonomic Blockade. I. Comparison Between the Effects of Tetraethylammonium Chloride (Teac) and High Selective Spinal Anesthesia on Blood Pressure of Normal and Toxemic Pregnancy 1

Assali¹,

Prystowsky²

1950

J. Clin. Invest.

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Treatment of the Acute Toxaemias of Pregnancy With Hypotensive Drugs

Kistner¹

1954

BJOG

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The Treatment of Eclampsia by Means of Regional Nerve Block

Cited by 2 publications

References 0 publications

Studies on Autonomic Blockade. I. Comparison Between the Effects of Tetraethylammonium Chloride (Teac) and High Selective Spinal Anesthesia on Blood Pressure of Normal and Toxemic Pregnancy 1

Studies on Autonomic Blockade. I. Comparison Between the Effects of Tetraethylammonium Chloride (Teac) and High Selective Spinal Anesthesia on Blood Pressure of Normal and Toxemic Pregnancy 1

Treatment of the Acute Toxaemias of Pregnancy With Hypotensive Drugs

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