Cahiers d'anesthésiologie
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Cahiers d'anesthésiologie · Jan 1996
Randomized Controlled Trial Clinical Trial[Value of ilio-hypogastric block in appendectomy in children].
This prospective study aimed to evaluate the efficiency of ilio-hypogastric nerve block for control of post appendicectomy pain in children. Forty-two children aged 3-15 years scheduled for appendicectomy were anaesthetized in the same way. After randomization, a preoperative ilio-hypogastric nerve block was performed in 21 patients. ⋯ Five inefficient blocks were recorded. No complications were noted. Ilio-hypogastric block was found to be safe and efficient for control of post-appendicectomy pain in most children.
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Cahiers d'anesthésiologie · Jan 1996
[Inhalation anesthesia in unusual situations: the Eole 2 NA ventilator].
The volumetric ventilator Eole 2 NA has been adapted to work as an anaesthesia machine with low flow or closed system. This modified device is very easy to use in exceptional situations: because of its strength and reliability; its favorable quality/price ratio; versatile electrical supply: mains (220 volts) or 24 D. ⋯ V. from internal battery (2 hours autonomy) or external battery (8 hours autonomy); gas economy: less than 1 L.min-1 of fresh gas flow, whether O2/N2O = 0.5 L.min-1 of each gas or 1 L.min-1 delivered by an oxygen concentrator. Clinical trials are discussed.
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The use of intraparenchymatous ICP sensor is becoming increasingly popular at the expense of the traditional intraventricular catheter method, in spite of the impossibility, with the former technic, to correct a possible zero drift. The decision to initiate or discontinue ICP monitoring is essentially based upon whether suggestive aspects of raised ICP are or not present on CT-scan. The degree of basal cisterns effacement is particularly informative. ⋯ Preceding the rise of ICP, there exists a compensation phase during which a progressive decrease of intracranial compliance is the important event. Even more earlier, posttraumatic cellular metabolic dysfunctions are to-day objectives for a neurochemical monitoring. Therefore a special technical and human environment has became mandatory to take a real benefit from ICP monitoring.
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Combined spinal-epidural anaesthesia (CSEA) is realized by one route immediately before the surgical procedure. It consists of: -a spinal anaesthesia for the operation itself. -followed by the installation of a catheter in the epidural space, so as to ensure postoperative analgesia. ⋯ Real contra-indications are few. Updated recent needles could certainly extend the field and general use of this technique.
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Sciatic nerve block is considered difficult to perform, but very useful for lower limb anaesthesia and analgesia. The use of a nerve stimulator makes the technique easier. Functionally, it is better to consider that there are three independent sciatic nerves, namely, the posterior cutaneous nerve, the tibial nerve and the common peroneal nerve. Searching for blocking these three nerves and especially the latter two, specifically improve the reliability and quality of blockade.