Annales françaises d'anesthèsie et de rèanimation
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Ann Fr Anesth Reanim · Jan 1986
Case Reports[Examination of the family of a patient susceptible to anesthetic malignant hyperthermia].
The familial nature of anaesthetic malignant hyperthermia must lead to the search for susceptibility in other members of the family of a sensitive subject. According to the literature, only in vitro studies of contraction characteristics of biopsied skeletal muscle fibres exposed to caffeine or halothane are of predictive value. Four members of the family of a patient who died as a result of malignant hyperthermia were investigated. The results expressed in accordance with the criteria defined by the European group on malignant hyperthermia, coupled with a histoenzymatic study, defined three of the subjects as HMN (negative) and one subject as HM (c) (equivocal or intermediate).
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In order to evaluate long-term intrathecal morphine therapy for cancer pain, whatever its location, 121 patients (80% were ambulatory patients) treated between April 1979 and April 1985 at the Cancer Institute of Montpellier (Centre Paul-Lamarque) were assessed. Morphine was stored in a presternal insulin syringe, protected by a sterile and waterproof dressing. A bolus administration of morphine via a subcutaneous lombo-epigastric subarachnoid catheter was scheduled every 12 h. ⋯ Nausea and vomiting were frequent but resolved spontaneously within a few days. Urine retention (33%) occurred mainly in men over 65 years, after pelvic surgery or radiotherapy. Because of the absence of a defined zone of analgesia, the small volumes required and the "ready for use" preparation, intrathecal isobaric morphine therapy will lead to easy self-administration via an implanted pump in the future.(ABSTRACT TRUNCATED AT 250 WORDS)
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Ann Fr Anesth Reanim · Jan 1986
[Radioimmunoassay method for the detection of IgE antibodies specific to alcuronium].
A radio-immunoassay (RIA) was used to screen for specific IgE to myorelaxants. Alcuronium was coupled to epoxy-activated Sepharose. Sixteen patients with anaphylaxis to alcuronium (n = 2), gallamine (n = 2) or suxamethonium (n = 12) were studied. ⋯ This test accounted for in vitro cross-reactivity, but had no predictive value for the clinical risk of crossed-anaphylaxis. This risk was best assessed by ID; it was positive in three cases. Although it was not possible to compare ID and RIA, the interpretation of which was different, both tests should be recommended for the detection of sensitivity to muscle relaxants.