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Anesthesiology. 1982 Aug;57(2):127-9.

Low-dose enflurane does not increase blood loss during therapeutic abortion.



A study was conducted to determine if uterine blood loss during therapeutic abortion could be kept to a minimum by utilizing relatively low concentrations of enflurane. The blood loss was compared to that observed when patients were anesthetized with a more routinely accepted nitrous oxide/narcotic technique. 34 healthy, unpremedicated, women undergoing elective suction abortion were studied. Patients ranged in age from 16-29 years and were at 8-13 weeks gestation. After informed consent was obtained, the patients were anesthetized with 1 of 2 anesthetic techniques. The 18 patients in Group 1 were given 50-100 mcg of fentanyl intravenously. Anesthesia was then induced with thiopental (4-5 mg/kg) and maintained with 70% nitrous oxide in oxygen. Additional thiopental was administered during the procedure in response to the patient moving, swallowing, breath holding, or exhibiting other signs of inadequate anesthesia. No additional fentanyl was required. The 16 patients in Group 2 had anesthesia induced with a small dose of thiopental (3-4 mg/kg) and maintained with 1% inspired enflurane and 66% nitrous oxide in oxygen. At no point was the concentration of inspired enflurane increased to more than 1%. Additional thiopental was administered in response to the same criteria as described for Group 1. There was no significant difference between the 2 groups in terms of the patient's gestational age or mean blood loss. Group 2 received approximately 1.7 mg/kg less thiopental than Group 1. No patient in Group 2 received fentanyl. The mean duration of anesthesia was 16.2 minutes for Group 1 and 17.4 minutes for Group 2. No patient in either group lost more than 180 ml of blood. There were no immediate postoperative complications, and all patients were discharged from the hospital approximately 2 hours after the procedure. Despite the fact that enflurane is known to relax uterine muscle, it has been shown that enflurane can be used safely for patients undergoing therapeutic abortion, in that it does not increase blood loss when compared to a nitrous oxide/narcotic technique. The use of enflurane in low concentrations as an anesthetic for outpatient abortion is advantageous because it obviates the need for narcotics or large doses of thiopental.

[Indexed for MEDLINE]

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