Cahiers d'anesthésiologie
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Cahiers d'anesthésiologie · Jan 1991
[Peridural obstetrical analgesia and the cicatricial uterus. A 4-year evaluation].
191 women with previous cesarean section in 291 indexed between October 1985 and September 1989 underwent a trial of labor. 146 patients received epidural analgesia in the course of labor. Vaginal delivery occurred in 126 patients (86.3%). Duration for epidural analgesia in labour was 163 +/- 110 min. ⋯ We report four uterine dehiscences and one rupture. In no case, epidural analgesia did not delay the diagnosis. The use of epidural analgesia for trial of labor in previous cesarean section did not increase maternal or fetal risk.
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Cahiers d'anesthésiologie · Jan 1991
Case Reports[A rare and serious complication of spinal anesthesia: bacterial meningitis].
Bacterial meningitis following spinal anaesthesia is a rare but serious complication. We describe a case in which an old woman received spinal anaesthesia for hip replacement. Diagnosing the aetiologic agent is a major medical challenge. The possible aetiological causes of this complication are discussed and the difficulty in differentiation between aseptic and bacterial meningitis noted.
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The aim of the regional administration of opioids is to provide an efficient and prolonged analgesia. Then, opiates can be useful for postoperative analgesia and for the treatment of chronic pain of malignant origin. Analgesia is correlated with several adverse effects of which the most frequent are nausea and itching and the most severe is respiratory depression. ⋯ Opioids also act by a reduction of the motor functions of the bowel, which perhaps could reduce the incidence of anastomotic breakdowns. Finally, other effects have been reported, as anecdotes, such as the treatment of spasm after bilateral replantation of the ureters, neurologic bladder dysfunctions and enuresis. Spinal administration of opioids has also been used as a treatment of premature ejaculation.
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Cahiers d'anesthésiologie · Jan 1991
Review[Secondary effects of opioids administered by the regional route].
The administration of narcotics in the subarachnoid or the epidural space is gaining acceptance for postoperative pain relief. However, the potential side effects of intrathecal and epidural use of opioids are the following: early and late respiratory depression, pruritus, nausea and vomiting, urinary retention. ⋯ Naloxone can be used to reverse the depression. Pruritus can occur in 10 to 30% of patients receiving morphine; 10 to 30% nausea and vomiting, and urinary retention occurs in 20 to 50% of patients.
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Cahiers d'anesthésiologie · Jan 1991
Editorial Comparative Study[The future of anesthesiology in France and trade unionism].