Annales françaises d'anesthèsie et de rèanimation
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Ann Fr Anesth Reanim · Jan 1992
Case Reports[Difficult intubation managed by laryngeal mask and fibroscopy].
A case is reported of a patient due to undergo a combined kidney and pancreas transplant who proved to be difficult to intubate. This diabetic hypertensive 35-year-old male patient also had ankylosing spondylitis. Mouth opening was normal (more than fingers' breadth), the chin-sternum distance was 4 cm on full cervical flexion, and cervical extension was only slightly impaired. ⋯ A paediatric fibroscope, passed through the LM tube, served as guide for the endotracheal tube. The mask was not removed, although its cushion was slightly deflated, so as not to extubate the patient. The benefits and usefulness of a laryngeal mask in predictable and unpredictable cases of difficult intubation are discussed.
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Ann Fr Anesth Reanim · Jan 1992
[Monochromatic infrared halogenated gas analyzer and handling errors].
Monochromatic infrared gas spectrometers cannot identify volatile agents. Such an analyser (Capnomac, Datex) was tested while performing two errors: a) erroneous selection of the agent on the analyser, the vaporizer being filled with the correct agent; b) total or partial filling of the vaporizer (Vapor 19, Dräger) with an incorrect agent, the analyser being set for the agent the vaporizer was specified for. Three agents were studied, halothane (H), enflurane (E) and isoflurane (I). ⋯ In case of erroneous filling of the vaporizer, the concentration displayed was always different from that expected. When E or I was delivered with an H vaporizer, the analyser being set on H, the concentration displayed was 3 to 9 times higher than the concentration that had been set. On the other hand, when H was delivered with an E or I vaporizer, the analyser being set to E or I, the concentration displayed was 4 to 8 times lower.(ABSTRACT TRUNCATED AT 250 WORDS)
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This study was carried out in 75 female patients, ranked ASA 1 or 2, during recovery from balanced general anaesthesia. It aimed to find out the main determinants of postoperative shivering and its thermal effects. Skin and oesophageal temperature were recorded every ten minutes. ⋯ However, the core temperature of those within that group that did shiver returned to normal levels more quickly than in those that did not shiver. These data underlined the essential role played by core temperature at the end of anaesthesia in postoperative shivering and its intensity, as well as the heat producing value of shivering. It would therefore seem logical to prevent postoperative shivering by avoiding intraoperative hypothermia.
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Ann Fr Anesth Reanim · Jan 1992
[Value of transcranial Doppler ultrasonography in patients with suspected brain death].
Transcranial Doppler ultrasonography (TCD) is a non invasive technique which assesses blood flow velocitics in basal cerebral arteries. Specific patterns have been observed in brain death. In a continuous series of 72 patients, the TCD recordings from the intracranial internal carotid and middle cerebral arteries were compared with the results from the usual investigations for brain death, such as electroencephalogramme (EEG), and arteriography. ⋯ TCD circulatory arrest preceded angiographic arrest by six hours in three cases. Hypotension was the main limitation to this technique. n the other hand, TCD may be used in patients treated with sedative drugs. The non invasive character of TCD, its low cost, the possibility of repeating it at the patient's bedside make TCD a very interesting diagnostic tool.(ABSTRACT TRUNCATED AT 250 WORDS)