Acta anaesthesiologica Belgica
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Acta Anaesthesiol Belg · Jan 1982
Techniques of ventilatory therapy in the adult respiratory distress syndrome (ARDS).
Techniques of respiratory support in ARDS are becoming more and more complex. New modes of ventilatory therapy like continuous positive airway pressure (CPAP), appeared during the last years and became popular; other ones are now under investigation, high frequency ventilation and extracorporeal CO2 removal, for instance. A lot of abbreviations are actually commonly used by physicians involved in intensive care as well as by ventilator industries. ⋯ The respective use of these different modes in our Center of Intensive Care at the University of Liège during recent years is analysed. It appears that mechanical ventilation, especially with positive end expiratory pressure (PEEP) keeps a place of choice and that spontaneous breathing with positive pressure (CPAP) represents one of the best improvements of the late years in respiratory intensive care. Last but not least is the absolute necessity to start respiratory assistance with positive pressure as soon as possible, once the diagnosis of ARDS is suspected.
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Acta Anaesthesiol Belg · Jan 1982
Comparative StudyDouble-blind comparison of the postoperative respiratory depressant effects of alfentanil and fentanyl.
Alfentanil was compared with fentanyl in a double blind study of 90 female patients undergoing laparoscopic sterilizations. The analgesic was combined with droperidol and etomidate for induction and with etomidate, nitrous oxide and occasional increments of succinylcholine for maintenance of anesthesia. Twenty-four percent of the patients required reversal of postoperative respiratory depression after fentanyl compared with 7% after alfentanil (p = 0.042). ⋯ However, 84% of patients were alert on awakening after alfentanil compared with 62% of patients after fentanyl (p = 0.032). Duration and quality of postoperative analgesia were similar in both groups. Cardio-vascular stability was satisfactory in all patients and side effects were minor and infrequent.
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Acta Anaesthesiol Belg · Jan 1982
Case ReportsAcute cardiovascular collapse after administration of suxamethonium.
The case is reported of an acute cardiovascular collapse immediately after the administration of suxamethonium to a 25-year-old woman undergoing a diagnostic laparoscopy under general anesthesia. Reintervention 14 days later--without the use of suxamethonium--was uneventful. A skin prik test with suxamethonium proved highly positive. A survey of the literature is given and an attempt is made to distinguish between true anaphylaxis and anaphylactoid reaction.
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Acta Anaesthesiol Belg · Jan 1982
Sciatic nerve block by the anterior and posterior approach for operations on the lower extremity. A comparative study.
The results of the analgesic block of the lower extremity by means of an anterior (150 patients) or a posterior (114 patients) approach to the sciatic nerve, associated to a "3 in 1 block" were compared. The anterior approach technique was associated with a higher incidence of failures, insufficient analgesia and hence a higher demand for intraoperative analgesic and sedative drugs. ⋯ However, the sciatic nerve block by anterior approach granted a more prolonged analgesia. This technique was suitable for trauma patients immobilized in the supine position, for patients with skeletal traction on Zupinger frame, both for surgery and for closed reduction of lower extremity fractures.
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Acta Anaesthesiol Belg · Jan 1982
Randomized Controlled Trial Comparative Study Clinical TrialInfluence of incentive spirometry on pulmonary volumes after laparotomy.
Twenty patients undergoing an upper abdominal procedure were randomly assigned in two groups. One group was treated with both chest physical therapy and incentive spirometry and the other was treated with chest physical therapy alone. ⋯ We observed that patients treated with incentive spirometry bad a faster return to preoperative pulmonary volumes. This observation confirms the prophylactic role of incentive spirometry in the prevention of pulmonary complications after laparotomy.