Annales françaises d'anesthèsie et de rèanimation
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Ann Fr Anesth Reanim · Jan 1993
Case Reports[Tetraplegia after colonoscopy: benzodiazepine withdrawal syndrome induced by flumazenil?].
A case is reported of a 68-year-old female patient who developed a flaccid tetraplegia on recovering from a colonoscopy, carried out under general anaesthesia (3 mg of midazolam, 20 mg of etomidate). During the preanaesthetic visit, she omitted to report a 15-year-addiction to lorazepam 2.5 mg every night. At the end of the procedure, 0.2 mg of flumazenil were injected. ⋯ She was discharged the same day but complained of myalgia and paraesthesia for a week. The physiopathology of this accident is unknown. The differential diagnosis and the influence of flumazenil on benzodiazepine withdrawal are discussed.
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Ann Fr Anesth Reanim · Jan 1993
Case Reports[Cerebral pneumocephalus after epidural anesthesia: a rare complication?].
A case is reported of pneumoencephalus occurring after an accidental dural puncture during a cervical epidural puncture using the loss of resistance technique. Six ml of air were injected intrathecally. ⋯ It may be difficult to differentiate between headache due to pneumoencephalus and that by stretching of the meninges due to cerebrospinal fluid leakage. Only a CT scan can help to answer this question.
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Ann Fr Anesth Reanim · Jan 1993
Predictive value of in vitro tests for the IgE-dependent and the IgE-independent anaphylactoid reactions to muscle relaxants.
Several aspects of in vitro tests for life-threatening anaphylactoid reactions (AR) to neuromuscular blockers (NMB, muscle relaxants) were addressed and highlighted. They include topics which have been under study in our centre in the past few years. Already available tests and newly developed ones were assessed for diagnostic and predictive value, as well as for usefulness in understanding of mechanism(s) of AR. ⋯ Lymphocyte stimulation tests may also be useful in such cases. RASTs cannot be advocated for general preoperative screening, as yet. Further development or selection of potentially "susceptible" subpopulations may improve the predictive value of these tests.
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Ann Fr Anesth Reanim · Jan 1993
[Biological changes in intra-uterine resections under glycine irrigation].
This study was carried out to assess the relations between plasma glycine concentrations and the biochemical changes occurring during intra-uterine resections (IUR) under glycine irrigation. Sixty patients with benign uterine conditions were included. They were all ranked ASA 1 or 2. ⋯ On the other hand, there was no correlation with the uterine pathological condition. In this series, five cases of uterine perforation occurred with very large biological variations, especially a decrease in haematocrit and osmolarity. In these cases a clinical and biological water intoxication syndrome may occur as a result of large volumes of irrigating fluid passing into the peritoneal cavity.