Cahiers d'anesthésiologie
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Administration of propofol in paediatric anaesthesia is relatively recent. Cardiovascular effects are minimal. Respiratory depression observed is in part in relation with the decrease of CO2 response. ⋯ Spontaneous movements during induction appeared chiefly with low doses. The most important advantage of propofol is the rapidity and the quality of recovery. Propofol has its place in paediatric anaesthesia and in addition sedation in intensive care unit is an new unexplored field.
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Cahiers d'anesthésiologie · Jan 1991
Case Reports[A rare and serious complication of spinal anesthesia: bacterial meningitis].
Bacterial meningitis following spinal anaesthesia is a rare but serious complication. We describe a case in which an old woman received spinal anaesthesia for hip replacement. Diagnosing the aetiologic agent is a major medical challenge. The possible aetiological causes of this complication are discussed and the difficulty in differentiation between aseptic and bacterial meningitis noted.
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Cahiers d'anesthésiologie · Jan 1991
Comparative Study[Techniques of autologous transfusion in hip surgery: a retrospective study].
A retrospective study was carried out on 99 patients undergoing hip surgery to evaluate the efficacy of three autotransfusion techniques on sparing of homologous blood. Preoperative normovolemic hemodilution (HDN), delayed autotransfusion (ATD) and recuperation of blood lost during surgery (RSPO) were studied. Patients were divided into 5 groups: group HDN, group ATD, group ATD + HDN, group RSPO, and the control group. ⋯ Recuperation of blood lost during surgery was least effective in sparing homologous blood (1 +/- 1.2 unit, p less than 0.02). Because of the moderate decrease in hematocrit, there are very few contraindications to delayed autotransfusion. Recuperation of blood lost during surgery should be associated with another autotransfusion technique.(ABSTRACT TRUNCATED AT 250 WORDS)
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Cahiers d'anesthésiologie · Jan 1991
Case Reports[Formation of a knot in a J spiral metallic guide: a complication of the Seldinger method].
Central venous catheter insertion by Seldinger's technique uses a wire guide which could be cause of complications. This case reports a blocked wire guide of which J tip was responsible for knotting. Utilization of vessel dilator of central venous catheterization set (Arrow) permitted to liberate and withdraw the wire guide without surgical operation. A larger use of this wire guide could increase the frequency of such complications.
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Cahiers d'anesthésiologie · Jan 1991
[Complications of local and regional anesthesia. An analysis of closed files of insurance companies].
We report a review of closed insurance claims for local and regional anaesthesia mishaps in the main private professional insurance companies. Twenty eight cases with extensive written documentation were discovered, spanning a 6 years interval between 1983 and 1989, involving 21 epidural, 6 spinal and 1 caudal anaesthesias, half with surgical and half obstetrical indication, and excluding all other blocks. Twenty four out of the 28 patients were relatively healthy. ⋯ Twenty two had a poor outcome: 8 deaths, 7 severe neurological injuries, a baby was dead and another child had severe neurobehavioral sequellae. The author points out the limitation of this study--a biased sample of all adverse events and inability to derive an incidence. However some of these events reveal patterns of anaesthetic management which lead to poor outcomes.