Annales françaises d'anesthèsie et de rèanimation
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Ann Fr Anesth Reanim · Jan 1995
Case Reports[Blood-patch treatment of headache occurring after post-dural puncture at the thoracic level].
A 23-year-old woman experienced headache following a high thoracic epidural analgesia to control postoperative pain after thoracoscopic treatment of a recurrent pneumothorax. On fourth postoperative day, a blood patch has been sited with 17 mL of autologous blood, injected into the thoracic epidural space at T1-T2 level, which was immediately effective. ⋯ The technique of thoracic blood patch is similar to the lumbar one, except some minor modifications. According to this case of a thoracic epidural blood patch which is seemingly the first one reported in the literature and our expertise with two other unpublished cases, a volume of 10 mL of blood may be sufficient and free of adverse effects.
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Ann Fr Anesth Reanim · Jan 1995
[Low back pain and headache during immediate postpartum. Role of obstetrical epidural analgesia].
The rate of low back pain and headache following parturition seems to be higher in patients delivered under epidural analgesia. The aim of this study, performed in the immediate postpartum (up to 3rd day) and including 200 patients delivered vaginally, was to assess the incidence and the risk factors of low back pain and headache. A total of 31.5% of them complained of low back pain (LBP+) after parturition. ⋯ The influence of epidural analgesia is questionable, as there was no difference between duration of labour and duration of epidural analgesia, if used, between the two groups. Patients for whom epidural analgesia was required are probably more susceptible to pain during pregnancy. Patients who suffered from postpartum headache (PPHDA+) were comparable to those who did not (PPDHA-).(ABSTRACT TRUNCATED AT 250 WORDS)
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Ann Fr Anesth Reanim · Jan 1995
Case Reports[Prolonged neuromuscular block after administration of mivacurium caused by plasma psueudocholinesterase deficiency].
Mivacurium is a new neuromuscular blocking agent with a short acting time of about 30 min, due to a fast hydrolysis by pseudocholinesterases. This metabolism carries a risk for prolonged neuromuscular block in case of an acquired or congenital pseudocholinesterase deficiency. ⋯ L-1). The likely cause was a congenital deficiency by a homozygote genetic mutation, as usual causes of an acquired deficiency had been eliminated.
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Ann Fr Anesth Reanim · Jan 1995
Case Reports[Cephalic cancer pain controlled by intraventricular administration of morphine and clonidine].
A 47-year-old woman suffered from a pharyngeal cancer causing pain only poorly relieved by high doses of oral morphine. Oral administration was switched to the intracerebroventricular (ICV) route but pain relief was only transient despite a daily dosage up to 1.5 mg of morphine. Finally an effective pain relief was achieved with increasing doses of clonidine (5 to 30 micrograms) in combination with morphine (1.5 mg) by ICV route. Neither arterial hypotension nor sedation occurred and the patient recovered transiently a better quality of life.
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Ann Fr Anesth Reanim · Jan 1995
[Cervicofacial cellulitis of dental origin and tracheal intubation].
To evaluate the difficulty of intubation in relation with the localisation and spread of cervico-facial cellulitis of odontogenic origin and to recognize the optimal technique of intubation in such circumstances. ⋯ The localisation of cellulitis of odontogenic origin is responsible for the difficulty grade of intubation. Awake fibreoptic intubation should be systematically performed in patients with a floor of the mouth cellulitis to reduce the risk of rupture of the abscess by a laryngoscope blade. As trismus associated with mandibular localisations is not relieved by general anaesthesia, awake fibreoptic endotracheal intubation should be preferred.