Annales françaises d'anesthèsie et de rèanimation
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Ann Fr Anesth Reanim · Dec 2013
Observational Study[Postoperative intravenous morphine titration in PACU after bariatric laparoscopic surgery.]
There is limited information available regarding intravenous (IV) morphine administration in obese patients in PACU. The aim of this study was to compare two IV morphine titration (IMT) regimen in two surgical centers. ⋯ Implementation of a IMT regimen in PACU was not associated with effective pain relief after laparoscopic surgery in obese patients.
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Ann Fr Anesth Reanim · Dec 2013
Case ReportsMaintenance of unconsciousness with low plasma propofol concentrations in the neohepatic phase of liver transplantation using bispectral index-guided propofol anesthesia: A case report.
The authors present a case where a drug-effect parameter, the bispectral index, was used to guide propofol infusion when propofol-remifentanil anesthesia was used for liver transplantation. The target concentration of remifentanil was kept constant throughout the operation, and the bispectral index indicated that propofol infusion was not required during the anhepatic and neohepatic phases of the operation. The measured plasma propofol concentrations during the neohepatic phase were far below the usual values that are used to maintain anesthesia. ⋯ The patient regained consciousness rapidly several minutes after administration of neostigmine and cessation of remifentanil infusion. The measured plasma propofol concentrations were similar before and after recovery of consciousness. The possible mechanisms for the maintenance of anesthesia at reduced propofol concentrations are multifactorial and may be related to reduced liver function as well as an interaction between propofol and remifentanil or the use of a neuromuscular relaxant to suppress somatic afferent activity.
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Ann Fr Anesth Reanim · Dec 2013
Comparative Study[Endotracheal intubation with the GlideScope(®), the Airtraq(®), the McGrath(®) videolaryngoscope and direct laryngoscopy: A comparative study on an infant manikin.]
The primary purpose of this experimental study was to compare intubation times for direct laryngoscopy with a Miller blade and for 3 VL: GlideScope® videolaryngoscope, Airtraq®, and McGrath®. ⋯ In this infant manikin model, the learning curve of the different VL was 3 attempts and the Airtraq® VL appears the airway device enabling the quickest orotracheal intubation. These experimental results need to be confirmed by clinical studies in infants and children.
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Ann Fr Anesth Reanim · Dec 2013
Observational Study[Impact of a trauma network on mortality in patients with severe pelvic trauma.]
To evaluate the impact of a regional trauma network on intra-hospital mortality rates of patients admitted with severe pelvic trauma. ⋯ The regional trauma network could screen the most severely injured patients with pelvic trauma to admit them at a level I trauma centre. The observed mortality of these patients was lower than the predicted mortality despite increased time from trauma to admission.
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An increasingly amount of evidence suggests that lung ultrasonography constitutes a relevant complementary diagnostic tool for adults patient in acute respiratory failure. A comprehensive and standardized ultrasonographic semiology has been described, relying on accurate and reproducible data directly obtained at patient's bedside. ⋯ Pioneers works in this field have suggested an attractive similarity between the ultrasonographic patterns described in adults and children. Nevertheless, the clinical usefulness of lung ultrasonographic approach in the pediatric critical care medicine still needs to be confirmed by specifically designed studies.