Cahiers d'anesthésiologie
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Cahiers d'anesthésiologie · Jan 1993
Review[Prevention and treatment of hypotension during spinal anesthesia].
Spinal and epidural anaesthesias alter self-regulation of arterial pressure as they lead to a sympathetic blockade. The extent and the speed of appearance of this blockade conditions the magnitude of the decrease of arterial pressure. ⋯ Correcting a deep arterial hypotension demands first of all the use of vasoconstricting agents the choice of which depends on the site of the anaesthesia and on the cardiovascular condition of the patient. The occurrence of bradycardia more often indicates a hypovolaemic state.
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Regional anaesthesia involves its own risks of which five main categories appear to stand out: 1. Excessive indications, especially of epidural anaesthesia instead of nerve blocks or general anaesthesia. 2. ⋯ Neurological complications of traumatic punctures, such as nerve root or dura mater injury. 5. Excessive complementary sedation.
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Cahiers d'anesthésiologie · Jan 1993
[Trans-sacral caudal anesthesia in ambulatory practice in infants. Our experience].
Sacral epidural block (S2 S3 intervertebral space, P. Busoni's method) is as safe and easy as caudal block. 11 children ASA 1 undergoing ambulatory surgery are studied (inguinal herniorrhaphy, undescended testis). Bupivacaine 0.25%, 0.5 ml.kg-1 is unsatisfactory, but anaesthesia is excellent with 0.8 ml.kg-1.
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Cahiers d'anesthésiologie · Jan 1993
Comparative Study[Shoulder surgery using a plexus block: for or against. Against].
Brachial plexus block is an alternative and elegant procedure for shoulder surgery. Three main concerns have to be considered when this technique is planed. ⋯ Thirdly, when nerve lesions of different mechanisms including plexus block itself occur, the origin of the lesion may be difficulty related to its cause. Indications of cervical block are therefore to be considered cautiously when shoulder surgery is performed.