Annales françaises d'anesthèsie et de rèanimation
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Ann Fr Anesth Reanim · Jan 1985
[Analgesia with an implanted device for repetitive intrathecal injections of morphine].
The use of intraspinal narcotics has been widely accepted as pain relief treatment for intractable cancer pain. Intraspinal low doses of morphine induce a potent selective long lasting analgesia. To avoid repetitive lumbar puncture, a drug delivery device was surgically implanted in 41 patients. ⋯ CSF leakage was noted in 11 patients; this was a challenge for us, as no other authors reported such a high rate for this complication. Aseptic meningitis was noted three times. In all cases but one, the symptoms resolved with appropriate treatment.
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Ann Fr Anesth Reanim · Jan 1985
Case ReportsCarbon dioxide embolism during laparoscopy and hysteroscopy.
Venous carbon dioxide embolism is a rare but potentially lethal complication of laparoscopy. The risk is increased when it is associated with hysteroscopy. ⋯ The patient had irreversible brain damage and died a week later. Early diagnosis and prevention of this serious complication are discussed.
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Ann Fr Anesth Reanim · Jan 1985
[Peridural morphine in intractable cancer pains. Means and obstacles].
Long-term analgesia with epidural morphine (EM) is a new tool in the management of intractable cancer pain. Twenty-six out of 160 cancer patients referred to the Pain Division for pain assessment were selected for analgesia with long-term epidural morphine, so aiming to define its place amongst more traditional methods of treatment, such as drugs, nerve-blocks, neurosurgery or radiotherapy. All 26 patients were cases of conventional analgesic failure, with very advanced cancer states. ⋯ Analgesic methods in cancer are palliative procedures. In terminal or temporary situations, other more invasive methods are not suited. The EM technique is simple, adjustable to advancing pain and has few side-effects, especially when compared with neurolytic and neurosurgical procedures.
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50 attempts of deep percutaneous antecubital catheterization are reported. A tourniquet was applied to the upper arm and the medial deep brachial vein was punctured in a point immediately medial to the brachial artery, in the antecubital fossa. Venepuncture was successful in 88% of the cases (44 cases), catheterization possible in 72% of the cases (36 cases). ⋯ The only benign complication was injury to the brachial artery in 6 cases. Mean duration of catheterization was 20 days. This very easy and safe technique can be used when superficial veins are unusable and use of the deep central veins dangerous or impossible.