Annales françaises d'anesthèsie et de rèanimation
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Ann Fr Anesth Reanim · Oct 1999
[A scale of perioperative satisfaction for anesthesia. I--Construction and validation].
To develop and to validate a scale assessing perioperative patient's satisfaction with anaesthesia (Evan). ⋯ A self-completed questionnaire on patient's satisfaction with anaesthetic period was validated, allowing a global and multidimensional assessment of patient's satisfaction.
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Prescription of opiates to non cancer chronic pain patients is controversial, partly because of the risk of tolerance and dependence development. The two objectives of that review were: a) to identify the factors which may explain the variability of tolerance and dependence in clinical practice; b) to analyse the cellular mechanisms of occurrence of those phenomenons. ⋯ Tolerance, defined as loss of opioid efficacy with time, is extremely variable and depends on pain mechanisms, intrinsic efficacy and administration modality of the opioid, as well as co-administration of other agents. Physical dependence is a consequence of the intrinsic and extrinsic adaptations concerning structures as locus coeruleus, paragigantocellular nucleus, spinal cord. Acute and chronic application of opiates and withdrawal give rise to cellular adaptations which depend on the nature and efficacy of the opiate, the type of receptor and second messengers, as well as the type of cell line under study. These cellular mechanisms have consequences on neuronal excitability and gene expression. They constitute a model of cellular tolerance and dependence, but cannot explain the subtelties encountered in clinical practice.
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Ann Fr Anesth Reanim · Oct 1999
Case Reports[Severe anaphylactic reactions after administration of rocuronium].
The authors report four cases of severe anaphylactic reactions (grade III or IV) to rocuronium bromide. In three of them, it was the first contact with a muscle relaxant. In three patients the reaction was mediated by IgE anti-bodies. A cross-reactivity with other muscle relaxants was existing in two cases (suxamethonium, vecuronium and atracurium in one patient, suxamethonium, vecuronium and pancuronium in the other.
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Ann Fr Anesth Reanim · Oct 1999
Comparative Study[A scale of perioperative satisfaction for anesthesia. II--Preliminary results].
To assess the patient's experience of anaesthesia in the early postoperative period, with a self-completed questionnaire (Evan). ⋯ The Evan questionnaire is a valuable tool for assessing the patient's opinion on the perioperative period. Further studies are required to extend its use to other fields, as ambulatory surgery.
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Ann Fr Anesth Reanim · Oct 1999
[Anesthesia consultation in cardiovascular and thoracic surgery. A survey of patient and physician satisfaction].
To assess the quality of the preadmission anaesthetic consultation prior to cardiovascular and thoracic surgery with a satisfaction inquiry. ⋯ This inquiry showed that the preadmission anaesthesia consultation was considered as benefitful by patients and anaesthetists. However the participation of patients in this study was poor. Subsequently to the inquiry information forms have been produced and handed to the patient prior to the consultation.