Annales françaises d'anesthèsie et de rèanimation
-
Ann Fr Anesth Reanim · Jan 1986
[Radioimmunoassay method for the detection of IgE antibodies specific to alcuronium].
A radio-immunoassay (RIA) was used to screen for specific IgE to myorelaxants. Alcuronium was coupled to epoxy-activated Sepharose. Sixteen patients with anaphylaxis to alcuronium (n = 2), gallamine (n = 2) or suxamethonium (n = 12) were studied. ⋯ This test accounted for in vitro cross-reactivity, but had no predictive value for the clinical risk of crossed-anaphylaxis. This risk was best assessed by ID; it was positive in three cases. Although it was not possible to compare ID and RIA, the interpretation of which was different, both tests should be recommended for the detection of sensitivity to muscle relaxants.
-
Ann Fr Anesth Reanim · Jan 1986
Randomized Controlled Trial Clinical Trial[Spinal anesthesia with bupivacaine for surgery of the hip in the elderly].
In 60 elderly patients, spinal anaesthesia for orthopaedic hip surgery was induced randomly with 15 mg bupivacaine 0.375% without glucose (Group I), 2.5% glucose (Group II) or 7.5% glucose (Group III), in 4 ml. The injection was made in the lateral position, and the patients turned supine immediately after. The onset, extent and duration of sensory and motor blockade, the cardiovascular effects and the quality of anaesthesia were evaluated. ⋯ It was suggested to take into account the more rapid infusion of lactated Ringer's solution (20 ml X kg-1) in Group III. Anaesthesia was satisfactory in 95% of patients in Group I and Group II, and 90% in Group III. Glucose-free bupivacaine produced a long-lasting blockade suitable for hip surgery of long duration.
-
Ann Fr Anesth Reanim · Jan 1986
Randomized Controlled Trial Comparative Study Clinical Trial[Maintenance of obstetrical analgesia by continuous perfusion into the peridural space].
Two methods of epidural analgesia were compared in two randomized groups each of 16 normal women in labour, using bolus or continuous infusion. Analgesia was provided by a mixture of bupivacaine 0.25% and fentanyl. ⋯ There was no statistical difference between the two groups concerning length of labour, number of forceps, Apgar score and patient, obstetrician and anaesthetist satisfaction score. Although continuous epidural infusion was greatly appreciated by the obstetrical team, it would seem to be of interest only when labour is long enough to require larger doses, especially when labour is induced.
-
Ann Fr Anesth Reanim · Jan 1986
Case Reports[Recurrent nerve paralysis and Claude Bernard-Horner syndrome following an interscalene block of the brachial plexus].
The association of a recurrent laryngeal block with a Horner's syndrome occurred in one patient after right interscalene brachial plexus block. Hoarseness was the main clinical symptom of recurrent paralysis and lasted 4 h. The subsequent course was totally uneventful and required no specific treatment. But the interscalene route of brachial plexus block may be potentially hazardous in the patient with a full stomach.
-
A case is reported of acute fatty liver of pregnancy with maternal and foetal survival inspite of jaundice, encephalopathy, renal failure, gastro-intestinal haemorrhage and serious coagulation problems. The acute fatty liver is a rare disease of unknown aetiology which occurs during the third trimester of pregnancy. Early diagnosis based on liver biopsy obtained by the transjugular route, immediate delivery of the foetus and intensive care improve an otherwise fatal prognosis.