Annales françaises d'anesthèsie et de rèanimation
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Ann Fr Anesth Reanim · Jan 2011
ReviewIs magnesium sulfate by the intrathecal route efficient and safe?
The polypharmacological approach to the treatment of postoperative pain has become routine in an attempt to minimize the adverse side effects of opioids. Magnesium sulphate is a noncompetitive antagonist of the N-methyl-d-aspartate (NMDA) receptor and thus can modify nociceptive modulation. ⋯ Several studies have shown that the administration of magnesium by the intrathecal route is safe and, in combination with opiates, extends the effect of spinal anaesthesia in both animal and human studies. The analysis of these studies justifies further investigation of the use of magnesium sulphate by the intrathecal route.
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Ann Fr Anesth Reanim · Jan 2011
Clinical Trial[Tranexamic acid reduces haematomas but not pain after total knee arthroplasty].
Tranexamic acid (TxA) reduces total blood losses (TBL) and allogenic transfusion (TH) after total knee arthroplasty (TKA). TBL can be external (surgical field, drains), or hidden (haematomas). Haematomas induce pain and limit postoperative rehabilitation. The aim of the study was to evaluate if TxA reduces haematomas and pain after TKA. ⋯ After TKA, TxA reduces the volume of hematomas, without any improvement in analgesia and rehabilitation until the sixth postoperative month.
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Ann Fr Anesth Reanim · Jan 2011
[Agreement between lung ultrasonography and chest radiography in the intensive care unit].
Because the chest radiograph currently remains the routine choice of imaging for the examination of the chest in the intensive care unit, we compared lung ultrasonography with chest radiography. ⋯ There was only moderate agreement between lung ultrasonography and chest radiography for the diagnosis of interstitial syndrome, alveolar consolidation and pleural effusion in intensive care unit. This result is mainly explained by the higher number of ultrasound abnormalities. With the ability to provide fast diagnosis, good reproducibility and high feasibility, ultrasound scan could represent an alternative exam for chest exploration in intensive care unit.
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Ann Fr Anesth Reanim · Jan 2011
Case Reports[Obstructive hypertrophic cardiomyopathy and caesarean section under combined spinal and epidural anaesthesia with prophylactic vascular ligation: regarding a case].
We report the case of a caesarean section under combined spinal and epidural anaesthesia in a pregnant 32-year-old woman with an hypertrophic obstructive cardiomyopathy. In these patients, variations of the ventricular load conditions may induce a cardiac inefficacy. ⋯ The arterial ligation according to the technique of Tsirulnikov is an alternative that we reported. This technique is followed by a good obstetrical prognosis.
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Ann Fr Anesth Reanim · Jan 2011
Case Reports[Bilateral catheter for continuous TAP block and postoperative pain relief after gynecologic surgery].
We describe the case of two patients who had undergone gynecologic surgery and in whom a continuous ropivacaine infusion was administered through a catheter placed on each abdominal side, using the technique of ultrasound-guided TAP block. Postoperative analgesia was of excellent quality with almost no morphine requirement. No side effects were encountered.