Annales françaises d'anesthèsie et de rèanimation
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Ann Fr Anesth Reanim · Jan 1995
[Severity scores underestimate the seriousness of acute renal failure after emergency surgery].
The predictive value of APACHE II and SAPS severity scores were evaluated in a group of patients with acute renal failure admitted in ICU after emergency surgery. The criteria of poor prognosis identified in the 24 hours following admission were also evaluated. ⋯ Conventional severity scores are inaccurate for prediction of mortality in patients with acute renal failure following emergency surgery.
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Ann Fr Anesth Reanim · Jan 1995
Clinical Trial[Continuous administration of mivacurium for short procedures. Delayed onset and recovery from neuromuscular blockade].
To assess the delays of onset and spontaneous recovery from neuromuscular block produced by mivacurium administered by continuous infusion for short procedure requiring a deep relaxation. ⋯ Mivacurium in continuous infusion provides rapidly a deep and stable neuromuscular blockade followed by a rapid spontaneous restoration of neuromuscular transmission in patients with normal pseudocholinesterases.
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Ann Fr Anesth Reanim · Jan 1995
Case Reports[Interscalenic block: accidental catheterization of the epidural space].
A case is reported of inadvertent insertion of a brachial plexus catheter into the cervical epidural space, at the sitting of an interscalene block for postoperative analgesia, during the recovery from general anaesthesia after surgical repair of a rupture of the rotator cuff of the shoulder. No features of cervical epidural anaesthesia were seen after the first injection of local anaesthetic, as it was made through the catheter insertion cannula. ⋯ The X-ray obtained after catheter opacification showed the penetration of contrast medium into the epidural space. In our case, two out of the three means of prevention of this complication were not possible: a) sitting of the interscalene block before induction of anaesthesia, as the insertion conditions of the catheter are better in a conscious, sitting patient; b) adequate cannula orientation (namely medial, dorsal and slightly caudal); c) routine X-ray control of the catheter position before the first injection, associated with careful clinical monitoring for 30 min after each local anaesthetic injection.
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Ann Fr Anesth Reanim · Jan 1995
[Anesthesia for hand surgery in patients with epidermolysis bullosa].
To report on the anaesthetic management with axillary block of patients suffering from recessive dystrophic epidermolysis bullosa (RDEB), undergoing repetitive surgery of the hand. ⋯ For surgery of the hand in patients with RDEB, we switched in 1988 from general anaesthesia with ketamine to axillary block, even in young children, as it is closer to the no-touch principle, which is essential to prevent from blistering. In comparison to general anaesthesia, regional anaesthesia raises neither the problems of airway and vascular access, nor those of instrumental monitoring. The main factors of success with regional anaesthesia are technical skills, expertise in the management of patients with RDEB and parental presence in the operating room which makes the procedure less stressful for children.
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Ann Fr Anesth Reanim · Jan 1995
Case Reports[Clostridium perfringens septicemia associated with foodborne toxic infection and abortion].
A 32-year-old pregnant woman with poor life and hygiene conditions presented with premature labour, fever and diarrhoea. After admission she gave birth to a stillborn child. ⋯ The outcome was favourable after an adapted antibiomicrobial therapy. This case illustrates the potential severity of Clostridium perfringens foodborne toxi-infection which can lead to abortion and septicaemia with massive haemolysis.