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Article
November 10, 1956

CONTROLLED RESPIRATION DURING CESAREAN SECTION

JAMA. 1956;162(11):1028-1030. doi:10.1001/jama.1956.02970280008003
Abstract

• The condition and behavior of 418 newborn babies were studied after delivery by cesarean section, and comparisons were made according to the type of anesthesia received by the mother. Group 1 consisted of 96 mothers who received spinal anesthesia; group 2, of 165 mothers who received general anesthesia (thiopental sodium, cyclopropane with oxygen, and sufficient dimethyl tubocurarine to maintain a quiet operative field); group 3, of 157 mothers who received thiopental sodium, cyclopropane with oxygen, and enough of either dimethyl tubocurarine or succinylcholine chloride to allow complete manual control of the mother's respiration. Data on the number of minutes elapsing before the baby cried loudly permitted quantitative analysis of the results. The incidence and severity of depression in the babies was found to be least when spinal anesthesia was given. Comparison of groups 2 and 3 showed that manual control of the maternal respiration resulted in much less depression in the infants of group 3 than was seen in the infants of group 2, who were dependent on the spontaneous maternal respiration. When general anesthesia becomes necessary in obstetrics, the plane of anesthesia should be kept as light as possible, the duration of anesthesia should be as brief as good teamwork by obstetrician, anesthesiologist, and nurses will allow, and the mother's respiration should be supplemented by full control of her breathing, so as to ensure the best possible oxygenation with best possible elimination of carbon dioxide for mothers and babies.

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