Anesthésie, analgésie, réanimation
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Anesth Analg (Paris) · May 1979
[Brachial plexus block anesthesia in the upper limb surgery (author's transl)].
This work, during a period of 2 years, has been carried out on 139 brachial plexus block anesthesias out of which --92 through axillary approach--47 through supraclavicular approach. Our failure rate was--6,5 p. cent in the case of the axillary block--10,6 p. cent in the case of the supraclavicular block. ⋯ We finally adopted two mixtures based on lidocaïne together with mepivacaine or bupivacaine keeping the same concentration but reducing to half the doses of these last two drugs. In our work, we have not noted any complication, and we think that a locoregional anesthesia, should, as far as it is possible, be used as a substitute for general anesthesia instead of being used when general anesthesia is contra-indicated.
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In sixty abruptions of the placenta observed during eighteen months, a severe condition of shock was observed in thirty per cent of patients. This shock state is seen during the abruption or after delivery. It's essentially a question of hemorrhagic shock, the importance of hemorrhagy being often underestimated, if the drop of blood pressure and blood losses are only estimated. ⋯ Heparinotherapy does not confirm the hope be suscited and seems to be a frequent source of ehmorrhagic complications in African women. Perfusion of fibrinogen, if useful, can be another source of complications. Rapid transfusion is the more effective treatment of abruption placenta and probably the less dangerous with strict control of the central venous pressure.
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Anesth Analg (Paris) · Jan 1979
[Neuromuscular block control during and after anaesthesia (author's transl)].
During many years the clinician's requirements for neuromuscular blocking drugs are satisfied by clinical investigations. Electromyographic recordings which are a satisfactory method are not useful in current practice. The use of nerve stimulators as Churchill Davidson apparatus modified for train of four impulses must reach the continental theatres, the response to neuromuscular blocking agents varying over a wide range. Five ways of stimulation can be used giving different informations, not only during anaesthesia, but so after particularly to specify the origin of some complications.