{"title":"[Epidural anesthesia in children under 3 months of age. Apropos of 49 cases].","authors":"P Courrèges, D Lecoutre, F Poddevin, R Bayart","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>This retrospective study includes 45 patients (age: 32 +/- 28 days; weight: 4,077 +/- 988 g) who underwent epidural analgesia with a catheter for various surgical operations. Epidural space was detected by the loss of resistance to air technique. The anaesthetic solution administered was bupivacaine 0.25% with 1/200,000 epinephrine. Four technical failures were recorded; intraoperative analgesia was adequate for all other patients. In 17 patients, postoperative analgesia was maintained by continuous infusion (0.125% bupivacaine or 0.25% lidocaine: 0.2 mL.kg -1.h-1). In 18 patients, it was managed by iterative injections (0.25% bupivacaine with epinephrine: 0.25 mL.kg -1.h-1). In 10 patients, a single shot was sufficient. Postoperative analgesia was found to be inadequate in four patients. No incidents or accidents were recorded. A benefit-risk analysis with the support of the literature attempts to define the main indications of this method.</p>","PeriodicalId":77055,"journal":{"name":"Cahiers d'anesthesiologie","volume":"44 5","pages":"403-8"},"PeriodicalIF":0.0,"publicationDate":"1996-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"20128626","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
J Escarment, J M Andreu, R Hervé, P Le Dantec, E Cantais, P Robert, J F Quinot
{"title":"[Combination of propofol-ketamine-vecuronium for total intravenous anesthesia under hazardous conditions].","authors":"J Escarment, J M Andreu, R Hervé, P Le Dantec, E Cantais, P Robert, J F Quinot","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>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. Recovery was fast and emergence reactions very limited. 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.</p>","PeriodicalId":77055,"journal":{"name":"Cahiers d'anesthesiologie","volume":"44 5","pages":"447-50"},"PeriodicalIF":0.0,"publicationDate":"1996-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"20129796","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"[Sciatic nerves block].","authors":"P J Zetlaoui","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Sciatic nerve block is considered difficult to perform, but very useful for lower limb anaesthesia and analgesia. The use of a nerve stimulator makes the technique easier. Functionally, it is better to consider that there are three independent sciatic nerves, namely, the posterior cutaneous nerve, the tibial nerve and the common peroneal nerve. Searching for blocking these three nerves and especially the latter two, specifically improve the reliability and quality of blockade.</p>","PeriodicalId":77055,"journal":{"name":"Cahiers d'anesthesiologie","volume":"44 2","pages":"119-26"},"PeriodicalIF":0.0,"publicationDate":"1996-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"19734171","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"[Anesthetic problems of epidermolysis bullosa dystrophica. Apropos of a case].","authors":"Y Gozal, D Gozal","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Epidermolysis bullosa is a group of hereditary diseases of the skin that may also involve mucous membranes, particularly of the oropharynx and oesophagus. The common primary feature is the formation of blisters following even trivial trauma. During the management of anaesthesia, it is critical that trauma to the skin and mucous membranes be avoided or minimized in these patients. We report the case of a 3-year-old child who had two surgeries and discuss the anaesthetic implications of this disease.</p>","PeriodicalId":77055,"journal":{"name":"Cahiers d'anesthesiologie","volume":"44 4","pages":"361-3"},"PeriodicalIF":0.0,"publicationDate":"1996-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"19992839","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
R Badaoui, T Thouvenin, M Riboulot, Y Bachelet, M Ossart
{"title":"[Unilateral spontaneous adrenal hematoma during the postpartum period. Apropos of a case].","authors":"R Badaoui, T Thouvenin, M Riboulot, Y Bachelet, M Ossart","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Spontaneous unilateral haematoma of the adrenal gland in post-partum is a rare event. We report a case in a 20 year-old woman without any medical history. The diagnosis could be suspected on upper abdominal pain and confirmed by sonography and CT-scan. There was no sign of endocrine dysfunction. Laboratory data were helpful to eliminate a phaeohromocytoma and histologic examination revealed only unilateral adrenal haemorrhage without tumour. Haematoma of the adrenal gland should be suspected in patients with upper abdominal pain without previous trauma, stress, or infection: however it occurs more frequently after severe stress and in association with other conditions. Surgery should be as conservative as possible.</p>","PeriodicalId":77055,"journal":{"name":"Cahiers d'anesthesiologie","volume":"44 4","pages":"369-71"},"PeriodicalIF":0.0,"publicationDate":"1996-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"19992841","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"[Erythrocytapheresis a few weeks before surgery: an alternative to erythropoietin treatment in programmed autologous transfusion].","authors":"J Bernière, I Gerota","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>The usual methods like hypotension, isovolaemic haemodilution, autologous transfusion and peri-operative blood salvage may significantly reduce the need for homologous blood transfusion in haemorrhagic surgery and also the risk of transmitting infectious agents. Erythropoietin (EPO) is now available and is used to stimulate red cell regeneration in pre-operative autologous blood donation. In acute anaemia, many studies have shown that the stimulation of endogenous erythropoietin production could be very high and accelerate red blood cell production. Taking higher quantities of blood than usual induces a secretion of endogenous erythropoietin, and could be an alternative for the utilization of exogenous EPO in autologous blood donation.</p>","PeriodicalId":77055,"journal":{"name":"Cahiers d'anesthesiologie","volume":"44 4","pages":"303-8"},"PeriodicalIF":0.0,"publicationDate":"1996-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"19990880","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"[Epidural anesthesia for labor].","authors":"P Dailland, P Chaussis, J Landru, H Belkacem","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Since the last decade, lumbar epidural analgesia has gained widespread use in obstetrics. Approximately 80% of parturients receive epidural analgesia for labour and vaginal delivery as well as caesarean section in most centres. There is little doubt that the most successful application of epidural analgesia during labour, considered by more than 75% of primiparas as extremely painful. The quality of analgesia is far superior to that which can be achieved by either parenteral or inhalation approaches and, unlike these methods, the mother remains alert. Epidural analgesia also prevents, or greatly diminishes, most of the physiological and chemical responses to labour pain that can be considered as stress responses, similar to those that have been described during surgery. There are considerable benefits, therefore, to both mother and child. Thus, epidural analgesia usually can be extended to relieve both uterine pain and pain related to distension of the lower birth canal, as well as providing analgesia for forceps delivery or caesarean section. Epidural analgesia allows the mother to be awake, minimizes or completely avoids the problems of maternal aspiration and avoids neonatal drug depression from general anaesthetics. If the most popular indication for epidural analgesia is the provision of pain relief, there are certain complications of pregnancy in which epidural analgesia appears to be indicated on therapeutic grounds such as pregnancy-induced hypertension, breech delivery, multiple pregnancy, incoordinate uterine action and fetal and/or maternal medical complications.</p>","PeriodicalId":77055,"journal":{"name":"Cahiers d'anesthesiologie","volume":"44 2","pages":"127-43"},"PeriodicalIF":0.0,"publicationDate":"1996-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"19733460","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}