Cahiers d'anesthésiologie
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Cahiers d'anesthésiologie · Jan 1996
Randomized Controlled Trial Comparative Study Clinical Trial[Evaluation of 2 dosages of fentanyl in caudal anesthesia. A prospective randomized double-blind study].
A caudal block is currently performed in children. A randomized and double blind study including two dosages of fentanyl: 0.5 microgram.kg-1 (group I) and 1 micrograms.kg-1 (group II) in association with bupivacaine 0.25% at a dosage of 1 mL.kg-1 was carried out. Two groups of 25 children undergoing urogenital or orthopaedic surgery participated in this study. ⋯ Furthermore, recovery of anaesthesia was rapid and calm. The frequency of nausea and vomiting was respectively 24% and 20% in groups I and II and did not require any specific therapy. Therefore it appears that caudal block with bupivacaine 0.25% and fentanyl 0.5 microgram.kg-1 is a very satisfactory technique in children when indicated.
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Cahiers d'anesthésiologie · Jan 1996
Review[Caudal and spinal anesthesia in sub-umbilical surgery in children. Apropos of 1875 cases].
Caudal and spinal anaesthesia are two techniques widely used in European children. The aim of this retrospective study was to evaluate the applicability of this practice in developing countries. The study concerned 1875 children, 1 day to 17 years old. isobaric 0.5% bupivacaine was used for spinal anaesthesia (n = 730) and mixture a of 1% lidocaine-0.25% bupivacaine with epinephrine 1/200,000 for caudal anaesthesia (n = 1,145). ⋯ Failure of the technique was less than 1%. These two regional anaesthesia techniques are easy to perform and are inexpensive. This is advantageous for developing countries.
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Cahiers d'anesthésiologie · Jan 1996
Review[Acute fetal distress. The anesthesiologist's point of view].
Foetal distress is a non-specific and imprecise diagnose sometimes associated with surgical delivery of a normal newborn. As this type of delivery is usually considered urgent, emergent anaesthesia is required. General anaesthesia is usually chosen in these cases because it is the quickest anaesthetic technique and because of fears concerning the haemodynamic consequences of regional techniques. ⋯ Mendelson's syndrome or to cope with a failed intubation drill is of greatest importance. Finally, comprehensive communication between the anaesthetic and obstetrical teams is one of the most useful ways to facilitate safer approach of the management of obstetric emergencies studies. Caesarean section for foetal distress.
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This review of postoperative analgesia after knee surgery provides a practical approach to the problem. The patient can be hospitalized or undergo day surgery, with different techniques being available for each situation. For day surgery, the intra-articular administration of local anaesthetic and/or opioids, the non-steroidal anti-inflammatory drugs can be used. ⋯ It must be emphasized that a combined approach using these different techniques may be useful in order to offer better analgesia and avoid some side effects. Each technique is described with advantages, side effects and practical usage its. The choice, in each professional environment, must be the best analgesic technique which can be performed safely.
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Cahiers d'anesthésiologie · Jan 1996
[Combination of propofol-ketamine-vecuronium for total intravenous anesthesia under hazardous conditions].
A total intravenous technique using propofol, ketamine and vecuronium was successfully used on 29 patients treated for elective surgery at the UNPROFOR French Medical Group (Sarajevo, Bosnia Herzegovina). Operative conditions were satisfactory for the surgeons. ⋯ No hypoxaemia was observed during the immediate postoperative period. The use of a propofol/ketamine/vecuronium combination is possible in field anaesthesia especially when opiates and inhalational agents are not available.