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Br J Anaesth. 1980 Aug;52(8):711-3.

Anaesthesia for termination of pregnancy.



This editorial looks at some of the various anesthesias used during pregnancy termination. Trichloroethylene, often a popular substitute for halothane, has been subjected to little evaluation. Only clinical study however, can actually establish the significance of myometrial depressant properties in the pregnant patient. Halothane has been extensively investigated and it was found that up to 0.8% halothane could be administered during cesarean section without an increase in blood loss. However, that amount was found to decrease arterial pressure and 0.5% was recommended as a supplement to nitrous oxide anesthesia. Any of the prospective studies of anesthetic technique and uterine blood loss all had difficulty in measuring blood loss accurately. Certain prospective studies whose results are presented provide the basis for the contention that halothane should be avoided as anesthesia in patients having their uteri evacuated. Blood loss following vacuum aspiration with trichloroethylene was found to be similar to the results with halothane and isoflurane and fluroxene appears to be associated with similar uterine blood loss. Based on the present level of knowledge, there is no clear evidence that a particular technique of general anesthesia is more less or likely to induce serious bleeding during surgical termination of pregnancy. A careful prospective study is needed in which the numbers are sufficient to establish real risk from any method of anesthesia and it should be considered whether the more elaborate techniques introduced in order to avoid the so-called risks of the inhalation method do not by themselves add new risks.

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