Cahiers d'anesthésiologie
-
Patient controlled analgesia improves titration of analgesic drugs, minimizing individual pharmacodynamic differences between patients, during the postoperative period. We describe the efficacy and the safety of intravenous PCA, based on the follow-up of 300 patients, recovering from upper and lower abdominal surgery. Successful use of PCA requires the choice of two important parameters: the PCA bolus and the lock-out period. ⋯ Patient's acceptance proved to be excellent and only 4 patients were not satisfied with PCA therapy. The incidence of respiratory depression was low (0.02%) and only one patient required naloxone. The side effects were dysphoria, nausea, pruritus and urinary retention; their incidence was low.
-
Cahiers d'anesthésiologie · Jan 1994
[Mechanical ventilation during MRI in children. Anesthetic constraints].
Early use of magnetic resonance imaging (MRI) excluded patients needing mechanical ventilation. However magnetic resonance imaging is an innocuous investigation and affords important elements to the diagnosis of many pathologies. Improvement of anaesthetic equipment have led to enlarge MRI applications considerably. ⋯ Although the ferromagnetic charge of presently used ventilators is greatly reduced, it is still necessary to keep them at some distance from the patient, with tubing of about 3 m, even in children. Therefore the compressible gas volumes are larger than the usual ones. For a tube length of 3 m, about 2-3 ml.kg-1 should be added to the standard tidal volume (10 ml.kg-1), so as to obtain safe normoventilation.
-
Cahiers d'anesthésiologie · Jan 1994
[Ambulatory anesthesia in ORL. Indication, limits and techniques].
Patients undergoing ENT surgery, mainly children, are excellent candidates for outpatient anaesthesia. Most surgical procedures are simple and do not require complicated techniques. Patient selection criteria have been defined by the "Société Française d'Anesthésie et de Réanimation" e.g. ⋯ Myringotomy and adenoidectomy and simple nasal or otologic surgery can be performed on an outpatient basis. Indications can be extended to other procedures that do not require hypotension and that meet selection criteria. Tonsillectomy and direct laryngoscopy could be performed on an outpatient basis in definite circumstances which have to be discussed for each patient.
-
The author introduces the modernization program for field medical facilities of the French military health service. It depends mainly on the manufacturing of containerized hospitals, the main features of which are: mobility, modularity and fast setup.
-
Cahiers d'anesthésiologie · Jan 1994
[HELLP syndrome and pregnancy hypertension: severity? Anesthetic management].
Four cases of HELLP Syndrome (Haemolysis, Elevated liver enzymes, Low Platelet count) (HS) have given the authors an opportunity for this brief review. HS should be evoked in any pregnant woman with high blood pressure during the last term, for it is a real emergency. Symptomatic treatment and rapid extraction constitute the commonly accepted therapy, by which maternal and foetal morbidity and mortality can be considerably reduced.