Cahiers d'anesthésiologie
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Regional anaesthesia in the setting of pre-hospital trauma care implies adverse conditions. Therefore some practical advices may be useful; avoid spinal or epidural anaesthesia, prefer safer lidocaine. ⋯ Main usable blocks are: brachial plexus block (axillary or interscalenic approach), radial, medial and ulnar nerve blocks, intercostal and interpleural nerve blocks, sciatic and femoral nerve blocks, superior laryngeal nerve block. Using a nerve stimulator is strongly advised in most cases.
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This article will briefly review the techniques of epidural anaesthesia via lumbar and sacral routes, as well as the indications and contraindications of the techniques. Guidelines for per- and postoperative use of epidural anaesthesia are provided.
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Cahiers d'anesthésiologie · Jan 1995
Randomized Controlled Trial Comparative Study Clinical Trial[Comparative study of sufentanil and fentanyl in urologic surgery in adults].
Sufentanil is compared with fentanyl as a supplement to N2O isoflurane anaesthesia in a double blind study of 30 elderly patients undergoing major urological surgery. Comparison is made with respect to 1) haemodynamic (heart rate, blood pressure) responses during surgery and recovery; 2) time to extubation after the end of surgery; 3) Postoperative analgesia. No difference is observed between the two groups with respect to demographic data, duration of surgery, and total doses of muscle relaxants. ⋯ Times between end of surgery and extubation are different: 77 +/- 13 min the sufentanil group versus 57 +/- 22 min the fentanyl group (p < 0.05). Use of analgesia is significantly delayed in the sufentanil group. It is suggested that sufentanil, in elderly patients, provides a better haemodynamic stability and a greater residual analgesia than fentanyl in the immediate postoperative period.