Annales françaises d'anesthèsie et de rèanimation
-
Ann Fr Anesth Reanim · Jan 1994
Comparative Study Clinical Trial Controlled Clinical Trial[Risk of secondary neuromuscular blockade after autotransfusion of blood drawn from the patient following curare administration].
A secondary neuromuscular blockade can occur after transfusion of autologous blood withdrawn after injection of muscle relaxants. In this study time course of muscle relaxation after transfusion of blood withdrawn before or after administration of atracurium (A) or vecuronium (V) was assessed. Forty adults undergoing haemorrhagic urologic surgery were included in the study. ⋯ The intensity of blockade was more important after vecuronium than after atracurium (p < 0.01 from T2 to T11 between groups A2 and V2). In group A2, the T4R had not reached the control level at the end of the procedure (0.78 at T11 vs 0.80 at T0). These data emphasize the importance of withdrawing blood units before administration of muscle relaxants.(ABSTRACT TRUNCATED AT 250 WORDS)
-
Ann Fr Anesth Reanim · Jan 1994
Review[Antibiotic prophylaxis of penetrating injuries of the abdomen].
Antibiotic prophylaxis for a penetrating injury of the abdomen has a distinctive feature as contamination occurs before administration of antibiotics and because important blood loss can modify the pharmacokinetics of antibiotics. Due to the rate and severity of infectious complications, no controlled study has been undertaken. ⋯ Various antibiotic regimens have been administered, but it seems that those using an antibiotic active against anaerobes are more efficient to prevent postoperative infectious complications than without them. There is no benefit to administer antibiotics for more than 24 hours.
-
Ann Fr Anesth Reanim · Jan 1994
[Training evaluation of the nursing staff in patient-controlled analgesia].
Intravenous patient-controlled analgesia (PCA) is an effective technique to relieve most forms of acute postoperative pain. However it is not easy to apply. An adequate training of the nursing staff has been for a safe and successful use in the recovery room and the wards as well. ⋯ There is no longer any resistance against the introduction of PCA in the wards. Training of nursing staff for the use of PCA devices is essential in order to avoid "human errors". PCA has become routine for the management of postoperative pain.
-
1. Propofol as an induction agent At a dose of 2 to 2.5 mg.kg-1, as a bolus injection over 30 to 60 seconds, for gynaecological procedures of short duration (abortion, D and C), propofol can be characterized as follows when compared with other induction agents: ADVANTAGES OVER METHOHEXITONE AND ETOMIDATE: decreased incidence of hiccups and abnormal movements, increased quality of induction, similar to that obtained with thiopentone, decreased postoperative nausea and vomiting. ADVANTAGES OVER THIOPENTONE: shorter recovery period, more rapid recovery of consciousness and orientation. ⋯ COMPARED WITH DESFLURANE: shorter induction time than desflurane, less respiratory problems at induction, similar recovery period, same incidence of nausea and vomiting. The administration of propofol for maintenance of anaesthesia has the main advantage of reducing the incidence of postoperative nausea and vomiting when compared to conventional halogenated anaesthetics. Respective costs of the various techniques, using propofol or the new halogenated anaesthetics, may be a criterion for choice in the future.(ABSTRACT TRUNCATED AT 250 WORDS)
-
Ann Fr Anesth Reanim · Jan 1994
Case Reports[Accidental subdural extra-arachnoid catheterization during epidural analgesia in obstetrics].
The authors describe a case of accidental catheterization of the subdural extra-arachnoid space during epidural analgesia for labour. The epidural catheter had been inserted at the L3-L4 interspace without any problem. A severe hypotension occurred 90 min after the onset of analgesia. ⋯ After delivery, a water-soluble contrast medium (10 mL of Omnipaque 180) was injected through the catheter and subsequent radiograph of spine showed subdural spread of the contrast medium. This complication might occur more frequently than usually thought and may be life-threatening. Anaesthetic management is discussed in the case of Caesarean section during labour.