Agressologie: revue internationale de physio-biologie et de pharmacologie appliquées aux effets de l'agression
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When tracheal intubation is conducted with traditional laryngoscope PtcO2 fall during the first minute after intubation; when continuous O2 supplied laryngoscope (Laryng O2) is used PtcO2 rise; the difference is statistically significant (p less than 0.001) either the subjects are in curarisation apnea or in spontaneous ventilation. With traditional laryngoscope, the fall is faster with spontaneous ventilation conditions than during curarisation apnea. Likewise in normal conscient subject the same fall is faster (p less than 0.001) during first minute of posthyperoxic spontaneous quiet ventilation than the first minute of voluntary hypocapnic apnea induced by hyperventilation during the same hyperoxia. Such results have to be taken into account for the indications of tracheal intubation technical means if hypoxic conditions are to be suspected, particularly for infants and subjects with cardio-respiratory failure.
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A simple method allows rewarming severe accidental hypothermia patients by an extra-corporal veno-venous circuit. Blood is removed from the femoral vein and brought to infusion pump accelerator which sends it through a blood-rewarmer before reinjecting it into the terminal jugular or sub-clavian vein. This allows the heart to be rewarmed preferentially. ⋯ No complications were encountered. Particularly, there were no incidents of shock due to rapid rewarming and no secondary biological disturbances observed imputable to the extra-corporal circuit. It should be emphasized that the equipment used is readily available in most Emergency and Intensive Care Units.
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Clonidine was administered by epidural injections with per os relay and long term therapeutic follow-up to 38 patients with deafferentation neurological sequellar pain either fully or partly intractable to classical pain treatments. In such types of pain, this technique provides hypoalgesia which can be enhanced by the administration of serotoninergic anti-depressants or low dose tricyclics. However, side effects may occur. After some time, a tolerance develops with a lesser antalgic efficiency, as well as rare cases of withdrawal syndromes when the treatment is suddenly discontinued.
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In 14 patients, spinal cord stimulation in lumbar radiculopathy follow multiple exploration or iterative surgery. For 10 out of this 14 patients treatment was successful; pain relief lasted a mean time of 12.7 months in 9 out of them.