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
Comparative Study[The importance of the preoperative measurement of hemoglobin concentration. Evaluation of a colorimetric method (Hemocue)].
The present study compares two methods of haemoglobin measurement during surgery in 40 patients aged 1 to 85 years. The reference method is the Coulter STKS based on red cell count and mean cellular content in haemoglobin measurement. The method tested (Hemocue-Diagnostics Transfusion) allows instantaneous determination of haemoglobin on a 10 mu sample by measuring infrared absorption by haemoglobin in the 565 and 880 nm wavelengths. ⋯ On capillary samples, there was a poor agreement between Hemocue and Coulter since the mean difference was -0.272 g/dl-1 with the following limits of agreement: -2.356 g/dl-1 and +1.812 g/dl-1. Only 92% of the observed differences were within the 95% confidence interval, with 17% of these being greater than the clinically accepted limit of 1 g/dl-1. The precision of Hemocue measurement of capillary blood haemoglobin was only +/- 16%.(ABSTRACT TRUNCATED AT 250 WORDS)
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Administration of propofol in paediatric anaesthesia is relatively recent. Cardiovascular effects are minimal. Respiratory depression observed is in part in relation with the decrease of CO2 response. ⋯ Spontaneous movements during induction appeared chiefly with low doses. The most important advantage of propofol is the rapidity and the quality of recovery. Propofol has its place in paediatric anaesthesia and in addition sedation in intensive care unit is an new unexplored field.
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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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Cahiers d'anesthésiologie · Jan 1991
Comparative Study[Techniques of autologous transfusion in hip surgery: a retrospective study].
A retrospective study was carried out on 99 patients undergoing hip surgery to evaluate the efficacy of three autotransfusion techniques on sparing of homologous blood. Preoperative normovolemic hemodilution (HDN), delayed autotransfusion (ATD) and recuperation of blood lost during surgery (RSPO) were studied. Patients were divided into 5 groups: group HDN, group ATD, group ATD + HDN, group RSPO, and the control group. ⋯ Recuperation of blood lost during surgery was least effective in sparing homologous blood (1 +/- 1.2 unit, p less than 0.02). Because of the moderate decrease in hematocrit, there are very few contraindications to delayed autotransfusion. Recuperation of blood lost during surgery should be associated with another autotransfusion technique.(ABSTRACT TRUNCATED AT 250 WORDS)