Agressologie: revue internationale de physio-biologie et de pharmacologie appliquées aux effets de l'agression
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Case Reports Randomized Controlled Trial Clinical Trial
[Comparison of adrenaline and clonidine to extend the analgesic effect of bupivacaine without glucose in spinal anesthesia].
So as to determine the effects of adrenaline and clonidine on the duration of isobaric bupivacaine spinal anaesthesia, a prospective controlled study was carried out on 20 ASA I or II patients. They were randomly allocated to two groups. The patients of group I were given 4 ml of a mixture including 3 ml of 0.5% bupivacaine, 0.2 mg adrenaline. ⋯ Regression times were 520.70 +/- 79.52 min for group II and 360.40 +/- 51.47 min. for group I. Significant prolongation of motor block was also associated with the addition of vasoconstrictors. It is concluded that addition of 0.15 mg clonidine may be useful to increase duration of isobaric bupivacaine spinal anaesthesia.
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Enterobacterial and pseudomonal carriage in the oropharynx, stomach and gut is uncommon in healthy individuals (apart from E. coli in the gut). Underlying intrinsic disease is the main cause of oropharyngeal and gastrointestinal carriage of 'abnormal' flora. ⋯ The oropharyngeal and gastrointestinal carrier state is the first stage in the development of nosocomial infections. Procedures aimed at the prevention of hospital infections via the abolition of the abnormal carrier state are termed selective decontamination techniques.
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Circumcision in children is followed by severe pain. This study analysed retrospectively anesthetic techniques of 110 children from 17 months to 14 years old who had undergone ambulatory of 24 h stay circumcision. There were two groups of patients: one being operated on under locoregional techniques combined with general anesthesia (53.6%), the other one under general anesthesia alone (46.4%). ⋯ In the first group, dorsal nerves block of the penis (DNBP) was performed on 47 children (79.8% of the locoregional techniques), caudal block on 10 patients and ring block on 2 patients. Regional techniques offered a satisfactory, safe and reliably effective post circumcision analgesia. DNBP should be used systematically in order to shorten duration of day circumcision stay.
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Thirty one epidural analgesias were performed in 23 ASA 1 or 2 infants ranged in age from 2 days to 1 year for orthopedic operation; 20 G needles were used for epidural puncture (25 with Potts-Cournand needles, 6 with Tuohy needles). A mixture of 0.5 mg.kg-1 0.5% bupivacaine, 0.5 mg.kg-1 1% etidocaine and 0.05 mg.kg-1 of morphine was administered. ⋯ Five accidental dural punctures occurred with Potts-Cournand needles, none were observed with Tuohy needles. Hemodynamic and respiratory parameters did not show significant variations.
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Bioethics always has been a great part of medicine, particularly actually in anaesthesiology. From either neonatal distress resuscitation of polymalformated babies or negative vital prognostic babies enduring numerous anaesthesia, to euthanasia for condemned and often suffering patients, there are numerous medical situations in anaesthesiology needing ethical thinking. ⋯ Then, what a singular relation. The patient confinding the anaesthetist all his vital functions without knowing him.