Annales françaises d'anesthèsie et de rèanimation
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Ann Fr Anesth Reanim · Sep 2013
Randomized Controlled TrialAn effective dose of ketamine for eliminating pain during injection of propofol: A dose response study.
Ketamine can completely eliminate pain associated with propofol injection. However, the effective dose of ketamine to eliminate propofol injection pain has not been determined. The purpose of this study was to determine the effective dose of ketamine needed to eliminate pain in 50% and 95% of patients (ED50 and ED95, respectively) during propofol injections. ⋯ Ketamine at an approximate dose of 0.3mg/kg was effective in eliminating pain during propofol injection.
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Ann Fr Anesth Reanim · Sep 2013
Review[Temporary epicardial pacing following cardiac surgery: Practical aspects.]
To review the practical aspects of temporary epicardial pacing following open heart surgery. ⋯ Temporary epicardial pacing following cardiac surgery is a simple method, more effective than transcutaneous pacing and easier to implement than transvenous pacing. Its practical management should be known by all physicians (anesthetists, cardiac surgeons) as well as paramedical personnel in order to avoid the risks of suboptimal functioning. A good practice protocol is proposed at the end of the manuscript.
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ICU acquired neuromyopathy (IANM) is the most frequent neurological pathology observed in ICU. Nerve and muscle defects are merged with neuromuscular junction abnormalities. Its physiopathology is complex. ⋯ IANM is usually diagnosed in view of difficulties in weaning from mechanical ventilation, but electrophysiology may allow an earlier diagnosis. There is no curative therapy, but early treatment of sepsis, glycemic control as well as early physiotherapy may decrease its incidence. The outcomes of IANM are an increase in morbi-mortality and possibly long-lasting neuromuscular abnormalities as far as tetraplegia.
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Ann Fr Anesth Reanim · Sep 2013
Observational StudyDelirium in older people after proximal femoral fracture repair: Role of a preoperative screening cognitive test.
Preoperative cognitive impairment has been identified as a major risk factor for postoperative delirium in older people. The aim of this study was to evaluate whether a validated and rapid screening cognitive test - COgnitive Disorder EXamination (CODEX) - performed preoperatively before proximal femoral fracture repair, was associated with a risk of postoperative delirium. ⋯ Abnormal preoperative rapid screening test CODEX is independently associated with postoperative delirium in older people undergoing hip fracture surgery and free of known dementia.
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Ann Fr Anesth Reanim · Sep 2013
Review[Improving vital organs perfusion by the respiratory pump: Physiology and clinical use.]
In this article, we review the effects of the respiratory pump to improve vital organ perfusion by the use of an inspiratory threshold device. ⋯ The clinical and animal studies support the use of the intrathoracic pump to treat different clinical conditions: hemorrhagic shock, orthostatic hypotension, septic shock, and cardiac arrest.