Annales françaises d'anesthèsie et de rèanimation
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Ann Fr Anesth Reanim · Jan 2010
Review Case Reports[Epidural analgesia and cutaneous angioma: need to perform MRI].
Epidural analgesia during labour is a well-accepted technique. Anaesthetists have to measure the risks of this technique during the first consultation with parturient. Complications, such as temporary or permanent neurological injuries due to this anaesthetic technique, are uncommon. ⋯ The likelihood of finding a spinal angioma with MRI is low and the modus operandi is infrequently modified. We report here a case of parturient with a cutaneous median angioma in the lumbar region, which was detected by MRI. An epidural analgesia was used for pain management during her labour.
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Ann Fr Anesth Reanim · Jan 2010
Review[Is there any place for hypertonic saline for fluid resuscitation in septic shock].
Fluid loading is the first step, necessary to care for severe sepsis. Two main classes of solutions are currently available: crystalloids and colloids. ⋯ Many experiments highlight modulation of immune and inflammatory cascades. We report the mechanisms of action of hypertonic saline based on experimental human and animal studies, which advocate its use in septic shock.
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Ann Fr Anesth Reanim · Jan 2010
Randomized Controlled Trial[Effects of hydroxyzine on tolerance of facial mask during induction in children].
To evaluate the effectiveness of hydroxyzine as a premedication agent for the acceptance of facial mask during induction of general anaesthesia in children. ⋯ Hydroxyzine provided better acceptance of facial mask than placebo during induction of general anaesthesia in children.
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The usual technique of parasacral sciatic nerve block seems an approach easily achieved, however, the ischial tuberosity is difficult to palpate. [1] The purpose of the study was to propose new skin landmarks improved by an anatomical and clinical study. ⋯ Access to the sciatic foramen appears to be facilitated by these new surface landmarks, which are simple and reliable. Our new skin landmarks seemed valid for all morphotypes.
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Ann Fr Anesth Reanim · Jan 2010
Case Reports[Successful use of recombinant factor VIIa in the control of a massive bleeding in two patients with biventricular assist device (Thoratec)].
Massive bleeding is a dreaded complication of biventricular mechanical assistance implantation. Its origin is multifactorial. Blood products transfusion associated with correction of coagulopathy are sometimes insufficient. ⋯ After surgical haemostasis failure and despite the correction of coagulation disorders, a major bleeding persisted, so these patients received a single injection of 90 microg/kg of rFVIIa. This allowed in both cases a significant reduction of the bleeding and the restoration of normal haemodynamic conditions. This treatment was not complicated by any thrombotic accident.