Annales françaises d'anesthèsie et de rèanimation
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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
Case Reports[Acute hepatic steatosis of pregnancy in an Addisonian patient].
A case is reported of acute fatty liver occurring in an Addisonian woman with a twin pregnancy. It is pointed out that Sheehan's syndrome or acute fatty liver of pregnancy is an exceptional cause of jaundice in pregnancy. ⋯ The best treatment is delivery by caesarean section, together with symptomatic treatment of the complications. In case of jaundice of unknown aetiology in late pregnancy, the advantages of an early diagnosis by transjugular hepatic biopsy are discussed.