Cahiers d'anesthésiologie
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Cahiers d'anesthésiologie · Jan 1995
[Difficult intubation: a prospective evaluation of the Mallampati and Wilson tests].
This prospective study aimed to evaluate in 849 patients the Mallampati and Wilson scores for predicting a difficult intubation. All scheduled patients were included. Induction and tracheal intubation were carried out as usual. ⋯ However, data from literature show a great variability of results between studies. Many factors may contribute to this variability: differences between samples of patients, evaluation of Mallampati or Wilson scale, protocols of induction and intubation or characterization of difficult intubation. This study suggests a poor reliability of the two tests.
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Cahiers d'anesthésiologie · Jan 1995
Biography Historical Article[Scientific anesthesiology of John Snow].
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Cahiers d'anesthésiologie · Jan 1995
Randomized Controlled Trial Comparative Study Clinical Trial[Analgesia with intra-articular injection of buprenorphine after surgery of the shoulder].
The effect of 10 ml of intra-articular buprenorphine (0.30 mg) or normal saline on postoperative pain after shoulder surgery was studied in a randomized, prospective, double-blind study in 30 ASA I-II patients receiving general anaesthesia. The pain scores (Five Point Scale ranging from "no pain" to "unbearable pain" and Visual Analog Pain Scale) 1, 2, 3, 4, 6 and 24 hours after surgery, time to first analgesic use and total 6-hours and 24-hours analgesic requirements were recorded. VAPS was significantly lower in the buprenorphine group compared with placebo-treated patients one hour after surgery (p < 0.05). ⋯ No significant differences were detected in total 24-h analgesic requirements between the two groups. These results indicate that intra-articular injection of buprenorphine after shoulder surgery provides short analgesia. This effect may be mediated by systemic absorption.
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Cahiers d'anesthésiologie · Jan 1995
Review[Optimal use of the administration of morphine derivatives].
During the postoperative period, the efficacy of opioid treatment is different among patients. Indeed, an extreme variability exists between patients, concerning their analgesic requirement and their sensibility to opioids. ⋯ The combination of different analgesics must be prescribed systematically, if there is no contraindication. 3) Opoid side effects must be appropriately treated, in order to improve the quality of analgesia. These simple measures require regular evaluation of opioid analgesia, and treatment of the side effects.
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General anaesthesia is often required for burns dressing. Ketamine was the most common agent for carrying out removal of adherent dressings. Disadvantages are delirium on emergence from anaesthesia and prolonged recovery. ⋯ Mean time of recovery was less than 15 min. Unpleasant dreaming occurred in 3 patients only, without agitation. The technique proved to be simple, effective and should revive interest for ketamine in the management of burned patients.