Annales françaises d'anesthèsie et de rèanimation
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Ann Fr Anesth Reanim · Jan 1990
Randomized Controlled Trial Comparative Study Clinical Trial[Intubation in otorhinolaryngologic surgery: propofol versus propofol-suxamethonium].
This study was carried out to assess the conditions of intubation in head and neck surgery when using propofol alone or associated with suxamethonium. Sixty patients were randomly allocated in two groups of 30. Group I was given 3 mg.kg-1 propofol and Group II 3 mg.kg-1 propofol immediately followed by 1.5 mg.kg-1 suxamethonium. ⋯ Opening of the glottis was found to be better in group II than in group I (p less than 0.01) and bucking was more frequent in group I (p less than 0.01). Successful intubation was obtained after one attempt at a similar rate in the two groups. The haemodynamic variations consisted in a significant decrease of systolic blood pressure compared to the initial value but these variations were similar in the two groups at each time (2.3 and 5 min) from induction.(ABSTRACT TRUNCATED AT 250 WORDS)
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Ann Fr Anesth Reanim · Jan 1990
Randomized Controlled Trial Comparative Study Clinical Trial[Comparison of enoximone versus tobutamine in the treatment of low cardiac output after cardiac surgery].
Enoximone, a new cardiotonic agent not related to glycosides or catecholamines, has been suggested for treatment of low cardiac output syndromes occurring after cardiopulmonary bypass (CPB). The aim of the present study was to compare enoximone with dobutamine in the management of such cases. Twenty consecutive patients who had undergone cardiac surgery with CPB and who had a cardiac index (CI) less than 2.5 l.min-1.m-2, pulmonary capillary wedge pressure greater than 12 mmHg, and no renal failure, were randomly assigned to receive either enoximone (group E, n = 10) or dobutamine (group D, n = 10). ⋯ No other inotropic drug was used during the study period. The aim was to obtain an increase in CI greater than or equal to 30% at the end of the first hour of treatment. Excessive systemic hypotension with low SVR was treated with volume loading.(ABSTRACT TRUNCATED AT 250 WORDS)
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Ann Fr Anesth Reanim · Jan 1990
Review Case Reports[Venous catheterization and congenital abnormalities of the superior vena cava].
Persistent left superior vena cava is encountered in about 0.3 to 0.4% of human beings. It derives from remnants of the left cardinal vein system. This results in either a duplication of the superior vena cava or in a single left vena cava. ⋯ Diagnosis was easily provided by angiography. Clinical course was uneventful. Despite its usual good tolerance, the persistence of a left vena cava, as an isolated anomaly, must not be neglected as it carries many practical implications which are reviewed.
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A new type of airway has been widely used for two years, throughout hospitals in the United Kingdom. Designed and created since 1983 by Dr AIJ Brain, the Laryngeal Mask Airway (LMA) is a compromise between the endotracheal tube and the face-mask. Blindly inserted in an anaesthetized patient, without either a laryngoscope or neuromuscular blockade, it provides a good airway in almost all cases. ⋯ The spontaneously breathing patient, undergoing elective surgery for 15 to 60 minutes, in supine position, who would ordinarily be managed with a face-mask is the more likely candidate for the LMA. But, longer procedures, in lateral or prone position, with controlled ventilation can usually be carried out using the Brain's device. More effective and less demanding than the facial-mask, much less hurtful than the endotracheal tube, the Laryngeal Mask is potentially an important and valuable addition to anaesthetic care.