Annales françaises d'anesthèsie et de rèanimation
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Ann Fr Anesth Reanim · Nov 2009
Comparative Study[Evaluation of flow rate regulators for intravenous infusion].
The aim of our study is to evaluate seven flow rate regulators (FRR) to assess the reliability of these devices compared to standard perfuser with roller clamp. ⋯ Our study exhibits the poor performances of the FRR studied: according to expected flow regulation, the reported results demonstrate the lack of accuracy. Their only one value added compare to the roller clamp is to improve the repeatability of the flow rate.
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Ann Fr Anesth Reanim · Nov 2009
[Pupillary dilatation monitoring to evaluate acute remifentanil tolerance in cardiac surgery].
Remifentanil is a powerful morphinic agonist often ordered for anaesthesia. The use of peroperative large doses of this opioid increases the risk to develop postoperative hyperalgesia and acute tolerance. But how early these effects can occur? Despite the fact that these effects could be masked during the preoperative time because of general anaesthesia, it seems they could occur precociously. In order to try to describe this time, this study evaluated the acute tolerance under general anaesthesia requiring large doses of remifentanil by using an effective peroperative monitoring of nociception: the continuous pupillary diameter monitoring. ⋯ The development of acute remifentanil tolerance could possibly explain these results. If evaluations with continuous pupillary diameter monitoring are still limited, these results suggest that the use of powerful opioids such as remifentanil should be associated with a N-methyl-D-aspartate (NMDA) receptor antagonist agent, including short time administrations.
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Ann Fr Anesth Reanim · Nov 2009
Case Reports[A case of malignant hyperthermia arising five hours after the beginning of anaesthesia with sevoflurane and after five uneventful surgical procedures].
We report a case of per anaesthesia malignant hyperthermia (MH) arisen in a 16-year-old young man presenting antecedents of five anaesthesia with use of halogenated agents without complication and having started a typical crisis of MH after five hours of anaesthesia with sevoflurane and with recurrence of the crisis after 14 hours in ICU. The association in the same clinical case of these three peculiarities of the crisis of MH already described separately in the international literature allows us to insist on their importance, with the French-speaking anaesthesiologists community.
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Ann Fr Anesth Reanim · Nov 2009
[National evaluation of knowledge and practice of cardiopulmonary resuscitation of children and infants in the field].
After the publication of new recommendations for cardiopulmonary resuscitation (2005 guidelines and 2006 French recommendations), we conducted a study amongst EMS teams concerning their approach with children and infants, nationwide. The objective was to measure the level of knowledge of guidelines and practice. ⋯ This study emphasizes the lack of knowledge, especially with regard to first aid. Formations will be developed.