Cahiers d'anesthésiologie
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This review describes the mechanisms of analgesic effect, advantages and risks related to the perioperative use of non steroidal antiinflammatory drugs (NSAID's). The NSAID's should be used as the first analgesic, around the clock, with a rapid onset of the therapy. Their combination with other NSAID's (acetaminophen) or opioids can have an additive analgesic effect and may limit frequent secondary effects as nausea and vomiting. Their potential toxicity must be remembered and the contra indications, maximum doses and duration of treatment have to be respected.
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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
Comparative Study[Postoperative analgesia after ligamentoplasty of the knee. Comparison of epidural morphine and intravenous nalbuphine].
Surgery of the anterior cruciate ligament causes severe postoperative pain. This study aimed to compare efficacy and side effects of two postoperative analgesia methods, during 24 hours. Twenty healthy patients were assigned to two groups (n = 10): the patients of the first group were given by an epidural catheter 3 mg of morphine hydrochloride, every twelve hours. ⋯ The incidence of respiratory depression, nausea, pruritus was not statistically different between the groups, but 7/10 patients in the first group suffered of urinary retention (the first micturition was obtained 10.5 hours after the end of surgery in the first group and 5.3 h in the second one). Two patients needed an uretral catheter. These results might tend to show a greater efficactly of epidural morphine, with a higher incidence of urinary side effects.
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Wound infiltration with a local anaesthetic may be used either to provide anaesthesia for superficial surgery or for postoperative pain relief. In the latter situation, its efficacy is real but remains moderate and usually requires a combination with other analgesics. Ilio-iguinal and ilio-hypogastric block has been shown to have an analgesic efficacy close to that obtained with a wound infiltration but the duration of analgesia may be longer. These blocks remain unfrequently used in adults.