Annales françaises d'anesthèsie et de rèanimation
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Ann Fr Anesth Reanim · Jan 1996
Randomized Controlled Trial Clinical Trial[Prevention of increase of blood pressure and intracranial pressure during endotracheal intubation in neurosurgery: esmolol versus lidocaine].
To compare the preventive effects of esmolol and lidocaine on the increase in mean arterial pressure (MAP) and intracranial pressure (ICP) during endotracheal intubation in neurosurgery. ⋯ Esmolol or lidocaine as an iv bolus of 1.5 mg.kg-1 before laryngoscopy and intubation do not completely prevent the increase in MAP and ICP.
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Ann Fr Anesth Reanim · Jan 1996
Practice Guideline Guideline[Difficult intubation. French Society of Anesthesia and Intensive Care. A collective expertise].
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Pneumatic tourniquets, often used to provide a bloodless operating field, carry a risk of adverse effects. Limb exsanguination by gravitation is less aggressive than by mechanical means. Skin, muscles, nerves and vessels suffer maximally under tourniquet because of mechanical pressure, with both a sagittal force, responsible for compression and an axial force responsible for stretchening. ⋯ In order to minimize its side effects, the tourniquet must be used within the frame of a strict procedure, with a well adapted and regularly checked equipment. Duration of ischaemia should be as short as possible and not continue for more than two hours, with a reperfusion of 15 minutes every hour. Local hypothermia seems to be a safe means for decreasing side effects.