Annales françaises d'anesthèsie et de rèanimation
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Ann Fr Anesth Reanim · Jul 2002
[Evaluation of the demand for access to peridural obstetrical anesthesia in maternity units].
This prospective study was initiated by a multicentric work. Each participating hospital, was asked to give data about 20 patients. Because of the importance of these informations for our practice, we decided to continue the evaluation, using the same inquiry, until 200 patients were enrolled. ⋯ This study underlined the fact that one third of parturients do not wish for an epidural analgesia, mainly out of fear for neurological complications. When the obstetrician indicated an EA, our organisation allowed its achievement in 98% of cases. The latency between arrival and EA should be shortened.
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A case of inability to remove an epidural catheter after vaginal delivery is reported. Surgical removal under general anaesthesia was attempted, but the catheter tip was sheared off inadvertently. Because the parturient was asymptomatic, it was decided to stop the operation and to leave the catheter tip into the epidural space. This complication is often related to excessive insertion of the catheter into the epidural space.
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Ann Fr Anesth Reanim · Jul 2002
Review[Inhaled nitric oxide in the peroperative period and recovery].
To analyse the current knowledge concerning use of inhaled NO (iNO) in anaesthesia and intensive care. ⋯ Persistent pulmonary hypertension is the sole demonstrated indication for iNO. Inhaled nitric oxide may be efficient in pulmonary hypertension, right ventricular dysfunction and severe hypoxemia. Inhaled nitric oxide must be considered as a rescue therapy or needs to be part of research protocols.
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To analyse the current knowledge based on the experimental and the clinical research studies focused on the main fields of cardiopulmonary resuscitation. ⋯ Many fields of cardiopulmonary resuscitation are investigated. Some relevant informations are included in the last international guidelines published in 2000, but most of them need complementary studies before other changes could be recommended for routine practice.
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The sitting position in neurosurgery may lead to complications such as air embolism and neurological complications. We report the case of a 16-year-old male who suffered from post-operation paraplegia after surgery for Arnold Chiari disease. This patient had several risk factors and serious morphological spinal abnormalities. We propose to include monitoring of somatosensory evoked potentials (SSEP) during this surgery in order to detect this type of devastating incident.