Annales françaises d'anesthèsie et de rèanimation
-
To study the reciprocal interferences between pregnancy and myasthenia gravis (MG) and to describe obstetric and anaesthetic management during labour and the post-partum period. ⋯ MG has no significant effect on the course of pregnancy and delivery, but MG exacerbation can occur, especially in the first trimester. Regional analgesia is medically indicated and must be performed early in labour, using low concentration of local anaesthetic to lessen the risk of motor block.
-
Ann Fr Anesth Reanim · Apr 2004
Case Reports[Haemodialysis, L-carnitine therapy and valproic acid overdose].
We report the case of a severe valproic acid poisoning in a 36-year-old man. In front of a high serum concentration of valproic acid at the admission, haemodialysis was initiated to decrease serum valproic acid concentration. A L-carnitine therapy (50 mg/kg per day) was also started. A cerebral oedema appeared at the third day, but the patient recovered without any sequela.
-
This review article presents a detailed analysis of patients' management for awake craniotomy, at the light of the available data in the literature and the authors' experience. Indications of this type of surgery are discussed as well as anaesthetic management itself, from preoperative assessment of the patient to peroperative concerns. ⋯ The authors emphasize the tricky aspect of the procedure, the necessity of rigorous patient selection and good preparation. They emphasize the need for controlled studies to validate the proposed techniques.
-
Ann Fr Anesth Reanim · Apr 2004
Review[Cerebral and systemic haemodynamic changes during neurosurgical recovery].
Major complications after intracranial surgery occur in 13-27% of patients. Among multiple causes, haemodynamic and metabolic changes of anaesthesia recovery may be responsible for intracranial complications. Recovery from neurosurgical anaesthesia is followed by an increase in body oxygen consumption and catecholamines concentrations. ⋯ This has been demonstrated in patients operated for subdural haematoma removal or undergoing carotid surgery. Prevention of hypothermia and pain are key factors to prevent metabolic changes. Beta-blockers seem to be suitable agents to obtain haemodynamic control in neurosurgical patients.