Cahiers d'anesthésiologie
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Cahiers d'anesthésiologie · Sep 1989
Randomized Controlled Trial Multicenter Study Clinical Trial[Dobutamine during anesthesia of patients at risk for heart failure. A controlled prospective multicenter study of 93 surgical patients over 64 years of age].
Most anaesthetic agents cause cardiac depression possibly hazardous in the elderly, especially in presence of a poor cardiac reserve. Ninety-three patients undergoing non cardiac surgery lasting more than 90 min. were entered in a double-blind multicentre randomized trial. They were 65 year old or more and unaffected by evolutive angina pectoris. ⋯ More arrhythmias and hypertensive episodes but less hypotensions occurred in group D. Substantial haemodynamic changes occur during anaesthesia and surgery in elderly patients. Dobutamine corrects the peroperative decrease in cardiac output and blood pressure, and might prevent postoperative neurological disorders.
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Cahiers d'anesthésiologie · Mar 1989
Comparative Study[Addition of a morphinomimetic to the continuous perfusion of 0.125% bupivacaine for peridural obstetrical anesthesia. A comparative study of fentanyl and alfentanyl].
Morphinic drugs added to epidural local anesthetic during labour enhance analgesia and obstetrical conditions. Fentanyl, 1 microgram/kg-1, is safe for the newborn. Alfentanil is of faster and shorter duration and its pharmacokinetics suggests less accumulation than fentanyl. ⋯ No cesarean section is observed. Neonatal status, established according to Apgar scores and then Amiel Tison neurological scales (0 to 30) respectively at 30 to 120 minutes are in the same favorable ranges: Apgar score is in all cases more than 9. The neurological score is 24 (group A) and 22.9 (group F) at 30 minutes and increases significantly at 120 minutes in the 2 groups (27 in the two groups).(ABSTRACT TRUNCATED AT 250 WORDS)
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Cahiers d'anesthésiologie · Jan 1989
[Circulatory and respiratory repercussions to direct suspension laryngoscopy in the adult: value of a propofol-alfentanil combination].
The clinical effects of a propofol-alfentanil association were studied in fifteen patients ASA II (mean age 50.1 +/- 14.1) anaesthetized for E. N. T. endoscopy after informed consent. ⋯ After an initial period of cardio vascular depression, the haemodynamic parameters did not vary much during the anaesthesia and propofol-alfentanil appeared to limit considerably the hypertension due to laryngoscopy. However, there was a moderate degree of hypercapnia (p less than 0.001) in most patients, giving evidence of some respiratory depression and possibly a greater depth of anaesthesia than desirable. Indeed, the doses of alfentanil required seemed to be more important with propofol because of a probably interference between the two drugs; the doses of these drugs should therefore be modified according to the length of surgery.