Annales françaises d'anesthèsie et de rèanimation
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A prolonged brachial plexus block with bupivacaine hydrochloride is described. Anaesthesia was induced with 40 ml of a solution made of equal parts of 0.50% bupivacaine hydrochloride and distilled water. Reversal of the motor block began 24 h later. ⋯ Whether this low osmolality caused nerve lesions was unknown. Postoperative exploration revealed a bilateral slowing down of conduction in the brachial plexus of this 73 year old patient. The importance of this finding could not be assessed.
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Ann Fr Anesth Reanim · Jan 1983
Comparative Study[Determination of the dose-effect curve of vecuronium in anesthetized man].
Dose-response curves have been determined in 37 healthy subjects, after injection of a single bolus of Organon NC 45 (vecuronium or Norcuron). The doses used were 0.0125, 0.025, 0.037 and 0.05 mg X kg-1. The ulnar nerve was stimulated at the wrist and the force of thumb adduction measured. ⋯ The effective doses (ED) were: ED50 at 0.024 mg X kg-1, ED90 at 0.034 mg X kg-1 and ED95 at 0.037 mg X kg-1. At 0.05 mg X kg-1, the degree of twitch inhibition was 99.2 +/- 0.6%, the delay of maximum effect was 7.7 +/- 1.4 min, and the length of action (up to 90% recovery) was 27.2 +/- 2.3 min. Vecuronium is therefore a potent neuromuscular blocking agent with a relatively short duration of action.
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Ann Fr Anesth Reanim · Jan 1983
Comparative Study Clinical Trial Controlled Clinical Trial[Epidural anesthesia using the bupivacaine-fentanyl combination for cesarean section].
This prospective study was designed to evaluate the benefit of a bupivacaine-fentanyl mixture vs bupivacaine alone in epidural anaesthesia for caesarean section. In 10 women, 0.5% bupivacaine (1.18 ml per metamer) was injected in the epidural space. In 20 women, 0.5% bupivacaine (1.06 ml per metamer) was injected by the same route together with fentanyl (1.70 +/- 0.09 micrograms X kg-1). ⋯ Fentanyl never induced any significant haemodynamic variations. Pruritus and nausea respectively occurred in six and two patients respectively in the bupivacaine-fentanyl group. In conclusion, in caesarean section, the adjunction of fentanyl to bupivacaine significantly improved analgesia without any clinical respiratory depression both in the mother and the neonate.
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Ann Fr Anesth Reanim · Jan 1983
Randomized Controlled Trial Comparative Study Clinical Trial[Clinical use of vecuronium during celioscopy].
In order to determine if vecuronium can be used for short operations, 40 women were studied during laparoscopy, randomly assigned to four groups: suxamethonium 1 mg X kg-1 in a single bolus followed by an infusion (group A), vecuronium 0.05 mg X kg-1 (group B), vecuronium 0.06 mg X kg-1 (group C) and vecuronium 0.07 mg X kg-1 (group D). Mean duration of operation was 22-25 min. Tracheal intubation can be performed in good conditions in all patients in group A and D, in 5/10 in group B and in 7/10 in group C. ⋯ We conclude that the time course of action of vecuronium 0.06 mg X kg-1 is that required for a pelvic laparoscopy of 22-25 min; however, the conditions of intubation are not always perfect. Intubation is easier with a 0.07 mg X kg-1 dose; this dose induces a slight delay for extubation and positive head lift test. In all cases, the patient must be closely watched in a recovery ward.
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Ann Fr Anesth Reanim · Jan 1983
[Surgical ligation of patent ductus arteriosus in the very-low-birth-weight premature infant].
Three recent cases of surgical closure of ductus arteriosus in very low birth weight infants (less than 1 000 g) are reported. The indications of both surgical and pharmacological closure in very low birth weight premature infants are discussed. The necessity of an early closure of a patent ductus arteriosus is now admitted in the very premature infant, but the use of indomethacin in the first days of life is often impossible because of its side-effects. The use of adapted non-invasive monitoring devices during surgery allows a better control of anaesthesia.