E. G. Co

Washington University Medical Center

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John B. Craft

American Cancer Society

Masahiro Yonekura

Nagasaki Medical Center

Robin Gilman

George Washington University Hospital

Paul Mazel

George Washington University

Michael F. Roizen

Case Western Reserve University

S. D. Dao

Washington University Medical Center

Leslie Shokes

Rancho Los Amigos National Rehabilitation Center

Lee A. Coaldrake

Washington University Medical Center

Anthony J. Trevor

University of California, San Francisco

Jim Johnson

University of North Texas at Dallas

Cooperative Institutions

University of California, San Francisco

Washington University Medical Center

George Washington University

American Society of Anesthesiologists

MCPHS University

Washington University in St. Louis

University of Southern California

George Washington University Hospital

Children's Hospital of Philadelphia

University of Pennsylvania

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INTRAVENOUS INJECTION OF BUPIVACAINE IN THE PREGNANT EWE

Anesthesiology (1979)

John B. Craft E. G. Co Masahiro Yonekura Michael F. Roizen Paul Mazel

10.1097/00000542-197909001-00309

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Citations (1)

BOLUS INJECTION OP CHLOROPROCAINE IN THE PREGNANT EWE

Anesthesiology (1980)

John B. Craft S. D. Dao Masahiro Yonekura E. G. Co David P. MacKinnon

Bolus (digestion)

10.1097/00000542-198009001-00313

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Citations (1)

Nitroglycerin therapy for phenylephrine-induced hypertension in pregnant ewes.

PubMed (1980)

John B. Craft E. G. Co Masahiro Yonekura Robin Gilman

Obstetrical situations in which endogenous or exogenous vasoactive amines precipitously increase maternal blood pressure and decrease uterine blood flow may be associated with increased maternal morbidity and mortality and with development of fetal acidosis and distress. We examined the effectiveness of nitroglycerin in lowering maternal blood pressure and increasing uterine blood flow during the infusion of the alpha-adrenergic agent phenylephrine. During the phenylephrine infusion maternal blood pressure increased 20%, cardiac output decreased 25%, total peripheral vascular resistance increased 60%, pulmonary arterial pressure increased 40%, uterine blood flow decreased 50%, and fetal arterial pH decreased from 7.37 to 7.30 (p less than 0.05). While maintaining the phenylephrine infusion at a constant rate, the infusion of nitroglycerin rapidly returned maternal systemic pressure and pulmonary arterial pressure to control values, decreased total peripheral resistance to 18% above control, increased cardiac output to 12% below control, increased uterine artery blood flow to 30% below control, and increased the fetal arterial pH from 7.30 to 7.35 (p less than 0.05). It is concluded that maternal hypertension resulting from intense alpha-adrenergic stimulation may be treated rapidly and effectively by the intravenous infusion of nitroglycerin with a partial restoration (20%) of uterine artery blood flow toward control.

Phenylephrine

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Citations (6)

MATERNAL AND PETAL CATECHOLAMINE RESPONSE TO KETAMINE

Anesthesiology (1980)

John B. Craft S. D. Dao Masahiro Yonekura David A. acKinnon E. G. Co

Departments of Anesthesiology and Obstetrics/Gynecology, George Washington University Medical Center, Washington, D.C. 20037*Department of Anesthesiology, University of California School of Medicine, San Francisco, California 94143.

George (robot)

10.1097/00000542-198009001-00319

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NITROGLYCERINE EFFECT IN THE HYPERTENSIVE PREGNANT EWE

Anesthesiology (1979)

John B. Craft E. G. Co Masahiro Yonekura Robin Gilman

10.1097/00000542-197909001-00308

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Citations (4)

Ketamine, catecholamines, and uterine tone in pregnant ewes

American Journal of Obstetrics and Gynecology (1983)

John B. Craft Lee A. Coaldrake Masahiro Yonekura S. D. Dao E. G. Co

Transplacental

Respiratory acidosis

10.1016/0002-9378(83)90823-2

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Citations (36)

Ketamine, Catecholamines, and Uterine Tone in Pregnant Ewes

Survey of Anesthesiology (1984)

John B. Craft Lee A. Coaldrake Masahiro Yonekura S. D. Dao E. G. Co

This study in the chronically instrumented pregnant ewe gives valuable new data on uptake and distribution of ketamine in both mother and fetus. It gives further credence, to that already obtained from clinical studies, that ketamine in doses of 1 mg. per kg. or less is safe for induction of general anesthesia, or in smaller doses for analgesia in the uncomplicated pregnancy. The associated increase in maternal arterial pressure is mild and is associated with an increased uterine blood flow. Likewise, the slight increase in uterine activity observed after these low doses is not coupled with fetal acidosis or compromised uterine blood flow. However, the safety of ketamine in pregnancies complicated by pregnancy-induced hypertension (PIH) has yet to be proved. In these conditions the maternal vasculature is constricted and hyperreactive, the uterine blood flow is reduced, and the uterus is markedly irritable. The benign response to ketamine in the uncomplicated pregnancy could be greatly exaggerated to the point of danger in both mother and fetus in PIH. Prudence demands that ketamine be avoided or used with caution in parturients with these disorders. Brett B. Gutsche, M.D.

10.1097/00132586-198406000-00062

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Citations (0)

Nitroglycerin Therapy for Phenylephrine-Induced Hypertension in Pregnant Ewes

Anesthesia & Analgesia (1980)

John B. Craft E. G. Co Masahiro Yonekura Robin Gilman

Obstetrical situations in which endogenous or exogenous vasoactive amines precipitously increase maternal blood pressure and decrease uterine blood flow may be associated with increased maternal morbidity and mortality and with development of fetal acidosis and distress. We examined the effectiveness of nitroglycerin in lowering maternal blood pressure and increasing uterine blood flow during the infusion of the alpha-adrenergic agent phenylephrine. During the phenylephrine infusion maternal blood pressure increased 20%, cardiac output decreased 25%, total peripheral vascular resistance increased 60%, pulmonary arterial pressure increased 40%, uterine blood flow decreased 50%, and fetal arterial pH decreased from 7.37 to 7.30 (p < 0.05). While maintaining the phenylephrine infusion at a constant rate, the infusion of nitroglycerin rapidly returned maternal systemic pressure and pulmonary arterial pressure to control values, decreased total peripheral resistance to 18% above control, increased cardiac output to 12% below control, increased uterine artery blood flow to 30% below control, and increased the fetal arterial pH from 7.30 to 7.35 (p < 0.05). It is concluded that maternal hypertension resulting from intense alpha-adrenergic stimulation may be treated rapidly and effectively by the intravenous infusion of nitroglycerin with a partial restoration (20%) of uterine artery blood flow toward control.

Phenylephrine

10.1213/00000539-198007000-00007

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Citations (9)