Annales françaises d'anesthèsie et de rèanimation
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Ann Fr Anesth Reanim · Jan 1986
Randomized Controlled Trial Clinical Trial[Effects of intermittent muscle stimulation on muscle catabolism in patients immobilized in the ICU].
Are muscular contractions obtained by electrical stimulation able to reduce muscle catabolism in immobilized patients? Ten patients (65 to 79 yr old), hospitalized in an intensive care unit for postoperative failure or cerebral infarction, were studied during nine days. Artificial nutrition was the same for each patient during the study. Two periods of four days where defined and randomized for each patient, separated by one day; during the stimulation period (S), intermittent electrical stimulation of the muscles of the legs (external electrodes) was performed daily 2 X 30 min; during the non-stimulation period (NS), muscular stimulation was not performed. ⋯ Results (X +/- SD) are as follows: the nitrogen balance (g/d) was -1.29 +/- 1.26 during the NS period and 1.43 +/- 1.10 during the S period (NS); 3-methylhistidine (mumol/kg/d) was 3.78 +/- 0.37 during the NS period and 3.15 +/- 0.32 during the S period (p less than 0.01); creatinine (mumol/kg/d) was 92.9 +/- 6.8 during the NS period and 72.9 +/- 25 during the S period (p less than 0.01). It is concluded that a significant decrease in 3-methylhistidine and creatinine excretions is observed during the S period. In intensive care unit patients, muscle protein breakdown may be influenced by intermittent electrical muscle stimulation.
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Ann Fr Anesth Reanim · Jan 1986
Case Reports[Contracture test with ionophore A 23187 for the diagnosis of malignant hyperthermia].
The results are reported of the contracture test obtained by using the calcium ionophore A 23187 (Calcimycin) in two patients, the son (A) and the mother (B). The past history of patient A revealed the occurrence of an impending malignant hyperthermia crisis during induction of anaesthesia in 1975. ⋯ It is suggested the A 23187 contracture test be added to the contracture tests as defined by the European Malignant Hyperpyrexia Group. This test could be of great help in identifying the percentage of relatives of MHS ("malignant hyperthermia susceptible") patients found to be MHE ("malignant hyperthermia equivocal").
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Ann Fr Anesth Reanim · Jan 1986
[Creatine phosphokinases and serum and urinary myoglobin following a procedure in prolonged knee-chest position for the treatment of spondylolisthesis].
Rhabdomyolysis following the knee-chest position was studied in 15 patients scheduled for surgery for spondylolisthesis. A comparison was made between 11 patients scheduled for orthopaedic surgery: ligamentoplasty (6 patients), total hip prosthesis (5 patients) and 11 patients scheduled for long oral surgery. The measurements carried out were blood CPK before surgery, 4, 8, 12 and 24 h after the beginning of surgery, and at days 2, 3 and 4. ⋯ In this series, rhabdomyolysis was real. CPK was not a good index of the release of haematic pigments, the only dangerous ones. A qualitative search for myoglobinuria is suggested, this being followed, or not, by alkalization to prevent acute renal failure.
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Ann Fr Anesth Reanim · Jan 1986
[Femoral nerve block as a postoperative analgesia technic in surgery of the knee].
A femoral nerve block was performed as a postoperative analgesic technique in 50 patients after knee surgery; this surgery is a very painful one. The technique used was the inguinal route, as described in the textbooks. ⋯ The average duration of analgesia was 600 min, the shortest being 300 min, the longest being 1,200 min. This technique can be recommended after surgery of the knee as safe and reliable.
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Ann Fr Anesth Reanim · Jan 1986
Case Reports[Expiratory blockage of a Monnal S respirator caused by rupture of the capsule of a pneumatic Bennett valve].
In the recovery room, a ventilated patient suddenly developed bradycardia and severe cardiovascular collapse due to increased airway pressure. The cause of this life-threatening complication was continuous occlusion of the expiratory valve by a ruptured diaphragm in a Bennett's valve. ⋯ On expiration, the expiratory gas under pressure penetrates the ruptured capsule, maintaining the valve occluded. A small part of the expired gas escapes through the small-bore connecting tube of the diaphragm.