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[Iatrogenic laryngotracheal stenosis. A follow-up of 20 recent cases]. 医源性喉气管狭窄。对最近20例病例的跟踪调查]。
Cahiers d'anesthesiologie Pub Date : 1996-01-01
E Wiel, T Depret, D Chevalier, B Vilette, C Erb, P Scherpereel
{"title":"[Iatrogenic laryngotracheal stenosis. A follow-up of 20 recent cases].","authors":"E Wiel,&nbsp;T Depret,&nbsp;D Chevalier,&nbsp;B Vilette,&nbsp;C Erb,&nbsp;P Scherpereel","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>The aim of this study was to analyse the follow-up of patients with a history of endotracheal intubation and/or tracheotomy because of respiratory distress, surgical necessity or long-term resuscitation. Twenty adults were followed up in a ENT facility for laryngeal or tracheal stenosis, of which 7 cases were diagnosed during 1994. This study shows that, in patients with a history of intubation, or intubation followed by tracheotomy, the stenosis developed within two months after resuscitation with a favourable outcome. After tracheotomy only, the stenosis developed later (2 months or more) with more recurrences. The diagnosis of stenosis was made on gradual or acute dyspnea. While respiratory resuscitation methods are essential and often life-saving, they are not without complications. Laryngeal and tracheal stenosis could be largely prevented by more careful techniques of endotracheal intubation and tracheotomy. Periodic endoscopic airway surveillance is useful to detect stenosis even when there is no clinical symptom.</p>","PeriodicalId":77055,"journal":{"name":"Cahiers d'anesthesiologie","volume":"44 1","pages":"43-8"},"PeriodicalIF":0.0,"publicationDate":"1996-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"19733991","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}
引用次数: 0
[Postoperative autotransfusion and transfusion evaluation in cardiac surgery]. 心脏手术后自体输血与输血评价
Cahiers d'anesthesiologie Pub Date : 1996-01-01
P Menestret, H Corbineau, T Langanay, J Valla, H Gouezec, M Sellin, H Le Couls, A Leguerrier, Y Logeais, Y Mallédant
{"title":"[Postoperative autotransfusion and transfusion evaluation in cardiac surgery].","authors":"P Menestret,&nbsp;H Corbineau,&nbsp;T Langanay,&nbsp;J Valla,&nbsp;H Gouezec,&nbsp;M Sellin,&nbsp;H Le Couls,&nbsp;A Leguerrier,&nbsp;Y Logeais,&nbsp;Y Mallédant","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>In cardiac surgery, blood retransfusion from the thoracic drainages, though already ancient, still remains controversial either for its quantitative or its qualitative interests. A retrospective study has been conducted, between the 1st january 1992 and the 30th june 1993, over 1.655 consecutive operations. Most of the patients suffered from coronary disease (937) or a valvular disease (605), others had been operated for a combined valvular and coronary revascularization surgery (113). The safety of this technique, guaranteed by strict rules, allowed a \"transfusional strategy\" which tends to reduce the homologous blood consumption. Twenty-nine percent of all the patients received homologous red cells units and only 23% of the patients operated for a coronary revascularization. This strategy aims to reduce both the risks of blood transfusion and the health cost.</p>","PeriodicalId":77055,"journal":{"name":"Cahiers d'anesthesiologie","volume":"44 1","pages":"49-54"},"PeriodicalIF":0.0,"publicationDate":"1996-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"19733992","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}
引用次数: 0
[Disseminated intravascular coagulations]. 弥散性血管内凝血。
Cahiers d'anesthesiologie Pub Date : 1996-01-01
P Amstutz, J S Moyo
{"title":"[Disseminated intravascular coagulations].","authors":"P Amstutz,&nbsp;J S Moyo","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Disseminated intravascular coagulation (DIC) syndromes can be defined as the formation of fibrin deposits within the microcirculation, occurring in definite clinical situations. Their biological counterpart is a consumption coagulopathy. The clinical profiles of DIC have been well known for decades, are multiform and range from latency to overwhelming haemorrhagic diatheses, including also characteristic but rare situations, such as purpura fulminans, acral cyanosis and pictures resembling thrombotic thrombocytopenic purpura or haemolytic-uraemic syndrome. Biological tests of DIC show a consumption coagulopathy, displayed on the standard haemostasis sheet; along with signs of paracoagulation and/or of secondary fibrinolysis (FDP). New tests have recently been introduced: D-dimers are specific and sensible; Antithrombin-III, protein C and alpha 2-antiplasmin also can sometimes be useful. The knowledge of the pathophysiology of DIC has made advances with passing years. Fibrin deposits may be non-occlusive, and indeed they are swiftly removed by a secondary fibrinolysis. Except in very rare situations, such as those leading to a cortical renal necrosis, and perhaps in some ARDS, there is little evidence relating DIC to organ failure syndromes. Moreover, there is no clear relationship between the severity of the consumption coagulopathy and the prognosis. For instance, the mortality is much lower in abruptio placentae, where the coagulopathy is very severe, than in septic shock, where it is usually moderate. In septic shock, the disorders of haemostasis were related initially to a platelet activation, then to an activation of the contact system (releasing kinins and triggering complement cascade), and nowadays to the activation of the extrinsic coagulation system. The treatment of DIC is mainly the treatment of its cause. Indications for heparin therapy should be strictly limited to a few exceptional circumstances. When haemorrhagic diathesis threatens, FPC and/or platelet transfusion may be indicated. Aprotinin can be useful in rare cases of overwhelming secondary fibrinolysis. Trials with antithrombin-III or C1-esterase inhibitors are in progress.</p>","PeriodicalId":77055,"journal":{"name":"Cahiers d'anesthesiologie","volume":"44 3","pages":"219-28"},"PeriodicalIF":0.0,"publicationDate":"1996-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"19964828","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}
引用次数: 0
[Coma caused by traumatic asphyxia: a severe neurological manifestation of Perthes syndrome]. [外伤性窒息引起的昏迷:珀尔特斯综合征的一种严重的神经学表现]。
Cahiers d'anesthesiologie Pub Date : 1996-01-01
M Ben Miled, A Smida, K Ben Fadhl, H Skouri, A Ben Maamer, A Cherif, F Najar
{"title":"[Coma caused by traumatic asphyxia: a severe neurological manifestation of Perthes syndrome].","authors":"M Ben Miled,&nbsp;A Smida,&nbsp;K Ben Fadhl,&nbsp;H Skouri,&nbsp;A Ben Maamer,&nbsp;A Cherif,&nbsp;F Najar","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":77055,"journal":{"name":"Cahiers d'anesthesiologie","volume":"44 3","pages":"229-30"},"PeriodicalIF":0.0,"publicationDate":"1996-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"19964829","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}
引用次数: 0
[Clinical study of a mivacurium-propofol combination for laparoscopic surgery in children]. [微真空-异丙酚联合应用于儿童腹腔镜手术的临床研究]。
Cahiers d'anesthesiologie Pub Date : 1996-01-01
E Hermonville, A M Devos, V Beaudoux, M Menard, F Bawab
{"title":"[Clinical study of a mivacurium-propofol combination for laparoscopic surgery in children].","authors":"E Hermonville,&nbsp;A M Devos,&nbsp;V Beaudoux,&nbsp;M Menard,&nbsp;F Bawab","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Coelioscopic surgery in children is today in constant progress and requires pharmacological agents which provide excellent surgical conditions for variable and unpredictable durations. The mivacurium-propofol association was clinically studied in this context in 30 ASA I patients aged from 6 to 16 years and appeared safe, efficient and easy to use. The orbicularis oculi and pollicis adductor stimulation allows simple and adapted neuromuscular blockade monitoring. Double-burst stimulation at the ulnar nerve improves the detection of a residual curarization.</p>","PeriodicalId":77055,"journal":{"name":"Cahiers d'anesthesiologie","volume":"44 3","pages":"261-5"},"PeriodicalIF":0.0,"publicationDate":"1996-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"19966738","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}
引用次数: 0
[Mesenteric infarction secondary to antithrombin III deficiency]. [抗凝血酶III缺乏继发的肠系膜梗死]。
Cahiers d'anesthesiologie Pub Date : 1996-01-01
M Miguil, C el Kettani, S Salmi, A Benslama, A Abdelouafi, O Abbassi
{"title":"[Mesenteric infarction secondary to antithrombin III deficiency].","authors":"M Miguil,&nbsp;C el Kettani,&nbsp;S Salmi,&nbsp;A Benslama,&nbsp;A Abdelouafi,&nbsp;O Abbassi","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>AT III is a physiologic inhibitor of blood clot formation: its deficiency is manifested by venous thrombosis. The authors reported case of mesenteric venous infarction in a 42-years-old woman. AT III deficiency was transient and caused by an oral contraceptive. In patients with AT III acquired deficiency it is necessary to suppress any risk factors of venous thrombosis.</p>","PeriodicalId":77055,"journal":{"name":"Cahiers d'anesthesiologie","volume":"44 4","pages":"357-9"},"PeriodicalIF":0.0,"publicationDate":"1996-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"19992838","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}
引用次数: 0
[Caudal and spinal anesthesia in sub-umbilical surgery in children. Apropos of 1875 cases]. 小儿脐下手术的尾侧和脊柱麻醉。关于1875个案例]。
Cahiers d'anesthesiologie Pub Date : 1996-01-01
A R Aguemon, G Terrier, A Lansade, J P Favereau, N Nathan, P Feiss
{"title":"[Caudal and spinal anesthesia in sub-umbilical surgery in children. Apropos of 1875 cases].","authors":"A R Aguemon,&nbsp;G Terrier,&nbsp;A Lansade,&nbsp;J P Favereau,&nbsp;N Nathan,&nbsp;P Feiss","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>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). Spinal anaesthesia was performed in neonates and infants (< 3 years) and caudal anaesthesia in children (aged 14 days to 17 years) undergoing urological and lower extremity surgery. No variation of heart rate, blood pressure or blood oxygen saturation (SpO2) were observed during surgery. 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.</p>","PeriodicalId":77055,"journal":{"name":"Cahiers d'anesthesiologie","volume":"44 5","pages":"455-63"},"PeriodicalIF":0.0,"publicationDate":"1996-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"20129703","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}
引用次数: 0
[Should we give up combining spinal anesthesia and anticoagulants?]. 我们是否应该放弃联合使用脊髓麻醉和抗凝血剂?
Cahiers d'anesthesiologie Pub Date : 1996-01-01
C M Samama
{"title":"[Should we give up combining spinal anesthesia and anticoagulants?].","authors":"C M Samama","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>The risk of lumbar haematoma potentially increased by the association of regional anaesthesia and anticoagulant treatment has been widely debated. Few data are available in order to estimate the level of this risk, which is probably very low. However, even if it is now clear that regional anaesthesia is not potent enough to prevent postoperative deep vein thrombosis (DVT), a partial decrease in the DVT rate between 30 and 40% has been observed. Furthermore, no randomized double blind study has established the usefulness of the preoperative injection of heparin. Accordingly, when it is possible, it is best to avoid the preoperative injection and to start heparin treatment postoperatively. This solution is safe and effective.</p>","PeriodicalId":77055,"journal":{"name":"Cahiers d'anesthesiologie","volume":"44 5","pages":"437-40"},"PeriodicalIF":0.0,"publicationDate":"1996-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"20129794","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}
引用次数: 0
[Venous surgery of the lower limb: value of nerve blocks]. 下肢静脉手术:神经阻滞的价值。
Cahiers d'anesthesiologie Pub Date : 1996-01-01
S Serri
{"title":"[Venous surgery of the lower limb: value of nerve blocks].","authors":"S Serri","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>The author describes his experience of 152 cases of saphenous veins surgery performed under sciatic and femoral blocks. These nerves were located by a nervestimulation. Femoral nerve was blocked under the inguinal ligament; the sciatic nerve is blocked by the posterior approach, at the buttocks. 152 patients, 136 cases were considered satisfactory: patients felt comfortable during and after the surgery; the stripper got up the vein more easily because of the vasoplegia; very good haemodynamic stability during changes in positioning; excellent nociceptive protection during the surgery. Sixteen cases were not satisfactory: the patient couldn't overcome his anxiety; the anaesthesiologist made technical mistakes; unbearable pain at the infero-internal face of the knee during the stripping. Considering these results, the blocks of the lower extremity could be an alternative to other anaesthetic techniques.</p>","PeriodicalId":77055,"journal":{"name":"Cahiers d'anesthesiologie","volume":"44 5","pages":"441-5"},"PeriodicalIF":0.0,"publicationDate":"1996-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"20129795","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}
引用次数: 0
[Hyperammonemia encephalopathy after ureterosigmoidostomy]. 输尿管乙状结肠造口术后高氨血症脑病。
Cahiers d'anesthesiologie Pub Date : 1996-01-01
G Donnard, J Dumotier, P Le Dantec, A Suppini, J F Quinot
{"title":"[Hyperammonemia encephalopathy after ureterosigmoidostomy].","authors":"G Donnard,&nbsp;J Dumotier,&nbsp;P Le Dantec,&nbsp;A Suppini,&nbsp;J F Quinot","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Ureterosigmoidostomy (USS) for bladder cancer is an attractive surgical technique for the improved quality of life provided to the patient, notably from a preserved body image. Complications, however, can jeopardize this result. We report the case of a woman who developed an hyperammonemic encephalopathy after USS \"Mainz pouch II\". We discuss the indication of a liver needle biopsy before USS when hepatic functions are abnormal and we stress the importance of regular \"rectal exonerations\" during the day.</p>","PeriodicalId":77055,"journal":{"name":"Cahiers d'anesthesiologie","volume":"44 2","pages":"149-51"},"PeriodicalIF":0.0,"publicationDate":"1996-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"19733462","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}
引用次数: 0
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