Annales françaises d'anesthèsie et de rèanimation
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Rapid fluid infusion remains the cornerstone for therapy of hypovolaemic shock. The principal limitations of flow rate are governed by the four variables of Poiseuille's law: tube internal diameter and length, viscosity of the fluid passing through the tube, and the pressure gradient between the two ends of the tube. ⋯ Dry-heat warming devices and microfiltration, to remove microaggregates and prevent non haemolytic febrile transfusion reactions, seem necessary when carrying out rapid transfusions. However, the use of microaggregate filters could be avoided by the routine production of leukocyte-poor red blood cell concentrates.
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Ann Fr Anesth Reanim · Jan 1990
Comparative Study[Pharmacokinetics of drugs used during the period of cardiac support].
Deep endobronchial instillation of epinephrine (2-5 mg in 5 ml saline, catheter of 50 cm in length), during cardiopulmonary resuscitation in man, results rapidly in efficient blood concentrations, similar to those obtained with i.v. route, but with the additional benefit of a more prolonged effect, due to a slower blood concentration decrease. Despite the large interindividual variations in resulting blood concentrations, also observed with the i.v. route, the endobronchial instillation of lidocaine (5-7 mg.kg-1 in 10 ml saline) results in most cases in blood concentrations located in the therapeutic range. ⋯ This can be of benefit for the prevention of recurrent ventricular fibrillation. This study provides further arguments for a more extensive use of the endobronchial route, especially in out-of-hospital resuscitation.
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Ann Fr Anesth Reanim · Jan 1989
Randomized Controlled Trial Comparative Study Clinical Trial[A combination of sufentanil and 0.25% bupivacaine administered epidurally for obstetrical analgesia. Comparison with fentanyl and placebo].
The study reported was designed to determine whether 15 micrograms sufentanil would provide analgesia comparable in duration and quality with that given by 75 micrograms fentanyl, when associated with plain 0.25% bupivacaine for extradural analgesia for labour. Patients (n = 124) in labour and at full term were randomly divided into 3 groups. Group 1 (n = 41) were given 12 ml of 0.25% plain bupivacaine with saline, group 2 (n = 41) 12 ml of 0.25% plain bupivacaine with 75 micrograms fentanyl and group 3 (n = 42) 12 ml of 0.25% plain bupivacaine with 15 micrograms sufentanil. 11 cases were excluded from the study (8 Caesarean sections, 3 technical failures). ⋯ The only side-effect seen with sufentanil and fentanyl was pruritus (group 2: 21.9%, p less than 0.05; group 3: 21.4%, p less than 0.05; group 1: 2.4%). These results showed that 15 micrograms sufentanil could replace 75 micrograms fentanyl for extradural pain relief of labour with plain 0.25% bupivacaine. However, the use of opioids with local anaesthetics would seem to be of interest only if labour is likely to be prolonged.