{"title":"[Locoregional anesthesia for injuries of the lower limbs].","authors":"J Barré, P Lefort, M Payen","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Isolated lower limb injuries are very common; difficulties for emergency anaesthesia may come from full stomach and drug interferences. The outcome of geriatric-fractured hip is influenced neither by a preoperative delay shorter than 48 hours, nor by the choice of anaesthetic technique; Nevertheless the use of acrylic cement is associated with an increased early mortality rate in hemiarthroplasties. Regional anaesthesia is the best choice for stable patients with a limited peripheral injury; The technique must be adapted to the pain induced by fracture; sitting position is useful for puncture. Spinal anaesthesia using 0.5% plain bupivacaine produces a block quickly achieved, not influenced by posture, allowing surgical installation and procedures. Postoperative analgesia using local anaesthetics may obscure symptoms of compartment syndrome which occasionally complicate tibial and femoral nailing.</p>","PeriodicalId":77055,"journal":{"name":"Cahiers d'anesthesiologie","volume":"44 3","pages":"197-201"},"PeriodicalIF":0.0,"publicationDate":"1996-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"19965517","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":"[Value of multidisciplinary approach in the management of back pain].","authors":"J L Husson","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":77055,"journal":{"name":"Cahiers d'anesthesiologie","volume":"44 3","pages":"245-7"},"PeriodicalIF":0.0,"publicationDate":"1996-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"19966735","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}
P Courrèges, M Peron, F Poddevin, D Lecoutre, R Bayart
{"title":"[Value of ilio-hypogastric block in appendectomy in children].","authors":"P Courrèges, M Peron, F Poddevin, D Lecoutre, R Bayart","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>This prospective study aimed to evaluate the efficiency of ilio-hypogastric nerve block for control of post appendicectomy pain in children. Forty-two children aged 3-15 years scheduled for appendicectomy were anaesthetized in the same way. After randomization, a preoperative ilio-hypogastric nerve block was performed in 21 patients. Twenty one were not blocked. The postoperative pain assessment showed a better analgesia in the blocked children group. Analgics were required less in group. Five inefficient blocks were recorded. No complications were noted. Ilio-hypogastric block was found to be safe and efficient for control of post-appendicectomy pain in most children.</p>","PeriodicalId":77055,"journal":{"name":"Cahiers d'anesthesiologie","volume":"44 4","pages":"293-6"},"PeriodicalIF":0.0,"publicationDate":"1996-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"19990879","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":"[Abdominal gunshot wounds. Ballistic data and practical management].","authors":"P Vicq, P Jourdan, O Chapuis, B Baranger","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>The mortality from abdominal gunshot wounds remains high, either in civilian or military cases. The severity factors of these wounds include bullet calibre and energy transfer of the missile. This paper studies some of the ballistics features of abdominal gunshot wounds. Practical guidelines are inferred concerning diagnosis and treatment of these wounds.</p>","PeriodicalId":77055,"journal":{"name":"Cahiers d'anesthesiologie","volume":"44 4","pages":"327-33"},"PeriodicalIF":0.0,"publicationDate":"1996-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"19992833","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 Le Mée, S Janny, J Belghiti, A Sauvanet, P Werner, J Marty
{"title":"[Is early extubation after surgery for esophageal cancer possible?].","authors":"J Le Mée, S Janny, J Belghiti, A Sauvanet, P Werner, J Marty","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>In a series of 50 patients undergoing elective oesogastrectomy through a laparotomy and a right thoracotomy, the avoidance of overnight ventilatory support was made possible by the agreement of anaesthetists and surgeons on suitable policies. The attempt to extubate the patients immediately postoperatively differentiated two groups. For the first group (32 patients; 64%), early extubation could be performed and only one patient was reintubated and required prolonged ventilation. A second group comprised 18 patients who could not be extubated early (36%). For most of the patients in this second group extubation was only delayed until the next day, and recovery was otherwise uneventful. In three cases, however, pulmonary atelectasis with infection was a major problem, and these patients required broncho-endoscopies, and prolonged ventilatory support. Nevertheless, morbidity and mortality after oesophagectomy were significantly reduced in this series, compared with a previous study in the same hospital. Careful postoperative assessment of the patient is essential. The main factors leading to the decision for early extubation appeared to be: absence of serious cardiovascular history, absence of peroperative surgical complications, adequate rewarming, normal chest X-ray, and the presence of clinical criteria for extubation along with adequate arterial blood gases. If the above criteria can be achieved, then early extubation should be routine and can be safely performed in the majority of cases.</p>","PeriodicalId":77055,"journal":{"name":"Cahiers d'anesthesiologie","volume":"44 5","pages":"409-13"},"PeriodicalIF":0.0,"publicationDate":"1996-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"20129788","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":"[Probable effect of hemofiltration on hemodynamics and tissue oxygenation in shock secondary to severe malaria].","authors":"D Hommel, F Michard, F Bollandard, A Hulin","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>The authors report a case of severe Plasmodium falciparum malaria in a French Guyana endemic area with secondary myocardial dysfunction treated by usual symptomatic therapy and continuous veno-venous haemofiltration (CVVH). Haemodynamic investigations revealed hyperkinetic shock and oxygen supply dependence. Haemodynamic remained critical under conventional therapy and CVVH was introduced. Haemodynamic parameters improved rapidly with reduced oxygen debt. In the absence of associated bacterial, viral and fungal infections, the systemic inflammatory response syndrome with shock and impairment of consciousness seems to be linked to severe Plasmodium falciparum malaria. The benefits and the probable mechanisms of action of CVVH are discussed.</p>","PeriodicalId":77055,"journal":{"name":"Cahiers d'anesthesiologie","volume":"44 2","pages":"163-6"},"PeriodicalIF":0.0,"publicationDate":"1996-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"19733466","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":"[Value of selective prescription of preanesthetic laboratory tests].","authors":"D Mignonsin, S Degui, M Kane, A Bondurand","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>The aim of this study was to determine the comparative value of routine or selective ordering of preoperative tests. 400 ASA I, II, III patients were enrolled in the study. Two periods were considered: a retrospective period where the patients (n = 200) underwent routine preoperative tests and a prospective period where the patients (n = 200) had only preoperative tests according to the results of questioning and clinical examination. During the retrospective period 1.408 tests were effected with 44 abnormal results. During the prospective period, the abnormal results among 855 prescribed tests were: 0.8% in ASA I patients, 7.5% in ASA II and 5.9% in ASA III patients. The ASA I patients had an average of 3.47 +/- 1.28 tests each, ASA II patients 4.50 +/- 1.21 and ASA III 7.50 +/- 1.50. No complication inducing sequelae or death could be linked to lacking tests. The mean cost of tests was reduced by 50 percent.</p>","PeriodicalId":77055,"journal":{"name":"Cahiers d'anesthesiologie","volume":"44 1","pages":"13-7"},"PeriodicalIF":0.0,"publicationDate":"1996-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"19733986","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":"[Attempted suicide in the aged].","authors":"L Picault, J M Le Gac","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Elderly people suicide or attempted suicide commands reflection. Some suicide-leading factors provide conspicuous risk markers. This retrospective analysis of 141 patients older than 65 yr, admitted in Lorient hospital emergency unit between 1986 and 1995, confirms the reality of risk factors, allowing to sketch a portrait of potential suicides so that preventive actions could be taken.</p>","PeriodicalId":77055,"journal":{"name":"Cahiers d'anesthesiologie","volume":"44 1","pages":"19-21"},"PeriodicalIF":0.0,"publicationDate":"1996-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"19733987","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":"[Computerized anesthesia record. How far have we gone?].","authors":"A Landais, E Peyry, O Dolhem, T Aviles, H Viard","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>There are more and more computerized anaesthetic records becoming available from various constructors. However, the setting up and operation of such a product depends on the development of concepts in computing. The second technological breakthrough, currently underway, is challenging principles which had seemed accepted up until now. The technical development concerns computer processing units, RAM or ROM. The development in software influences the operation of networks, multiple task and object programming. The graphic interface becomes the centre of this second revolution. All of these developments should be included in the proposed computerized anaesthetic records. Three factors determine the realisation of such a product: control of the data collecting process, the man-machine interface and the utilisation of storing data. The computerized anaesthetic record should be of open conception, allowing communication with all of the data bases and providing an interface with all the monitors and ventilators used in operating and recovery rooms. Now is the time to install the infrastructure network in operating and recovery rooms and to be thinking of acquiring the new generations of computerized anaesthetic records.</p>","PeriodicalId":77055,"journal":{"name":"Cahiers d'anesthesiologie","volume":"44 1","pages":"27-33"},"PeriodicalIF":0.0,"publicationDate":"1996-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"19733989","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":"[Resuscitation in severe hepatic injuries].","authors":"E Wodey, M Artus, Y Mallédant","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Hepatic injuries account for about 45% of all abdominal traumas and for 30 to 40% of penetrating abdominal injuries. In 60% of the cases, they are associated with other lesions, especially life-threatening head injuries. Abdominal ultrasonography, a short and safe procedure enabling guided puncture, has developed rapidly relegating to the second rank other diagnostic techniques such as peritoneal lavage and CT scan. First line treatment of severe trauma complicated by haemorragic shock combines fluid resuscitation, prevention of hypothermia and administration of broad spectrum antibiotics. Surgical care, relying mainly on perihepatic packing and vascular exclusion techniques must remain as conservative as possible. Once haemodynamics have been stabilized in patients who do not present any other abdominal lesion requiring laparotomy, the non-interventional attitude is often successful and bears lower morbidity.</p>","PeriodicalId":77055,"journal":{"name":"Cahiers d'anesthesiologie","volume":"44 1","pages":"55-69"},"PeriodicalIF":0.0,"publicationDate":"1996-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"19735252","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}