Annales françaises d'anesthèsie et de rèanimation
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Ann Fr Anesth Reanim · Jan 1997
Randomized Controlled Trial Comparative Study Clinical Trial[Effects of CO2 and adrenaline on 1% lidocaine in axillary block].
To compare lidocaine hydrocarbonate and lidocaine hydrochloride, with and without adrenaline, in the axillary block obtained with a neurostimulator. ⋯ Considering the cost/benefit ratio and the absence of clinical benefits of lidocaine hydrocarbonate, lidocaine hydrochloride should be preferred.
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The occurrence of a fat embolism syndrome (FES) can be explained by two hypothetic mechanisms. In the mechanical hypothesis, bone marrow enters into the cardiovascular system during an intramedullary peak pressure. This peak could occur during either long bone fracture and/or intramedullary nailing or cemented or noncemented arthroplasty. ⋯ Aprotinin and heparin are beneficial in counteracting blood cell aggregation. A prophylactic use of vena cava filters has been advocated. Prevention or early treatment of hypovolaemia and hypoxaemia are essential.
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Ann Fr Anesth Reanim · Jan 1997
[Defective gas mixers, a cause of retro-pollution of medical gas distribution pipelines].
A defective Air/O2 mixer of a ventilator located downstream of the gas outlets of two pipelines is a potential cause of retropollution. Retropollution of O2 with Air or vice versa carries a risk of either a) a hypoxic gas mixture delivery during anaesthesia, including O2-N2O administration, when the O2 pipeline supplies Air instead of O2, or b) a hyperoxic gas mixture delivery in the intensive therapy unit for neonates during administration of a O2-Air mixture, when the Air pipeline supplies O2 instead of Air. A defective O2/N2O flowmeter-mixer of an anaesthesia machine, with N2O flow control by O2 through a differential pressure manometer, can cause retropollution of O2 supply pipeline with N2O or vice versa. ⋯ The mixer or flowmeter-mixer responsible for retropollution can be recognized in plunging successively the various quick couplers underwater into a glass, while the others remain connected to their outlets and the mixer set at a O2 concentration of 50 vol% or the flowmeters set at a similar flow. In case of retropollution, the gas reflow produces bubbles. It is recommended: a) in anaesthetic areas to set the O2 pressure at about 0.2 bar above that of Air and the latter at a pressure of about 0.2 bar above that of N2O; b) in intensive therapy units for neonates, to set the Air pressure at about 0.2 bar above that of O2; c) in all areas to disconnect from the gas outlets the devices equipped with a mixer or a flowmeter-mixer when not in use.
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Ann Fr Anesth Reanim · Jan 1997
Letter Case Reports[Anesthesia of phantom limb during spinal anesthesia].