Cahiers d'anesthésiologie
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The advantages of regional over general anaesthesia have led to an increased use of peripheral nerve blocks. Among the few risks of regional anaesthesia are those of overdosage, systemic and neural toxicity. Techniques have been proposed to improve the success of peripheral nerve blocks and to avoid nerve damage or systemic toxicity. Nerve stimulator, anatomic landmarks, needles and anaesthetic solutions are discussed.
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Cahiers d'anesthésiologie · Jan 1995
Randomized Controlled Trial Clinical Trial[Effects of preoxygenation methods on the course of PaO2 and PaCO2 in anesthetic post-induction apnea].
This study compares two preoxygenation techniques by blood gases measurements during induction of anaesthesia. After hospital ethics committee approval, 17 adult surgical patients, ASA I, all free of cardiac or lung disease were randomly assigned to two groups. Before preoxygenation, venous and radial artery canulations were performed. ⋯ The group I had significantly higher PaO2 immediately after preoxygenation (397 +/- 49 vs 293 +/- 86 mmHg) and the time for SaO2 to decrease to 95% was significantly shorter in group II (3 +/- 1 vs 1.87 +/- 0.99 min). PaCO2 was not different after preoxygenation in group II. In summary, healthy and young patients receive better protection against hypoxia with normal breathing of 100% for 4 minutes.
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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.