Cahiers d'anesthésiologie
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Cahiers d'anesthésiologie · Jan 1996
[Study of a protocol of intra-articular analgesia after arthroscopy of the knee].
The purpose of this study was to assess the analgesic effects of intra-articular injection of a morphine-bupivacaine combination following knee arthroscopy. 47 patients were evaluated. Knee arthroscopies were all performed under general anaesthesia, using propofol, alfentanil, isoflurane and nitrous oxide. Analgesic effects were evaluated by a visual analogic pain scale. ⋯ Analgesia was good in the immediate postoperative period, with minimal side effects. The serum bupivacaine levels were low. However the analgesic efficacy of intra-articular injection of morphine-bupivacaine should be corroborated through a double blind study.
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Cahiers d'anesthésiologie · Jan 1996
Case Reports[Anesthetic problems of epidermolysis bullosa dystrophica. Apropos of a case].
Epidermolysis bullosa is a group of hereditary diseases of the skin that may also involve mucous membranes, particularly of the oropharynx and oesophagus. The common primary feature is the formation of blisters following even trivial trauma. During the management of anaesthesia, it is critical that trauma to the skin and mucous membranes be avoided or minimized in these patients. We report the case of a 3-year-old child who had two surgeries and discuss the anaesthetic implications of this disease.
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Cahiers d'anesthésiologie · Jan 1996
[Intraosseous device of perfusion. Apropos of 3 cases before hospitalization].
A renewal of interest in the intraosseous route has appeared lately in France. It concerns pediatric patients. ⋯ Our modest experience enables us to present three observations where intraosseous route has been used outside hospital in children suffering a cardiopulmonary arrest on arrival of the practitioner belonging to the mobile emergency unit. This rapid and easy to place technique seems to be attractive as an alternative to the intravenous route in situations of utmost emergency, this all the more so since there are few reported contraindications and complications.
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This retrospective study concerns 1,373 adult patients who underwent forefoot surgery during 1988-95 under regional anaesthesia by ankle nerve blocks (of posterior tibial nerve systematically and other nerves according to the surgical site). As a rule, plain bupivacaine 0.5% (maximum 40 mL) was used, completed if necessary by lidocaine 1% (a few mL). A nerve stimulator is currently used for posterior tibial blocks. ⋯ No general anaesthesia was needed (except after one case of convulsions, likely from accidental injection of a few mL of local anaesthetic and without any sequelae). Five patients complained of temporary paraesthesias, with indication of a posterior tibial neurolysis in one case and complete recovery. Thus ankle blocks appear increasingly to be a satisfactory alternative to general anaesthesia for most surgical procedures on the forefoot, provided that all usual safety conditions are respected and the patient's acceptance of the procedure is obtained.
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Cahiers d'anesthésiologie · Jan 1996
Biography Historical Article[History of anesthesia: Frederic Hewitt and nitrous oxide anesthesia].