Annales françaises d'anesthèsie et de rèanimation
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Ann Fr Anesth Reanim · Jan 1985
Case Reports[Anesthesia for emergency cesarean section after uterine rupture associated with recent fracture of the cervical spine].
General anaesthesia with intubation is preferable for emergency Caesarean section, whilst epidural anaesthesia should be reserved for elective Caesarean section. The case of a patient who required emergency Caesarean section following uterine rupture is discussed. ⋯ This avoided tracheal intubation and the possibility of worsening the cervical fracture. The end result was satisfactory, both for the mother and the child.
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The histamine releasing potential of atracurium was assessed by testing skin reactivity in ten patients who had previously suffered from a preanaesthetic anaphylactoid accident, but in whom the diagnosis of anaphylaxis had not been confirmed. Atracurium was injected intradermally in increasing concentrations so as to determine the reactivity level, comparing it in the same patient with that due to d-tubocurarine and alcuronium given in the same way. Skin tests with histamine and 48/80 were also carried out at the same time. ⋯ All the commercial muscle relaxants together with atracurium were tested, even though none of the patients had ever received this last. Anaphylaxis was confirmed when the intradermal reaction was positive with a dilution of 1 in 1,000 and beyond. These tests showed that five patients out of the six had a crossed anaphylaxis, and one of these five was sensitive to all four muscle relaxants (atracurium included).(ABSTRACT TRUNCATED AT 250 WORDS)
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Postoperative pain was treated by epidural administration of 30 to 50 mg pethidine (5 mg X ml-1) in a group of 36 patients who had undergone retropubic prostatectomy. Surgery was carried out under epidural anaesthesia with lidocaine. Pain was assessed by means of the visual analogue scale. ⋯ There was a significant decrease in pain at the first hour after injection; differences in pain scores at the third hour were not significant. No noticeable side-effect was observed. It was concluded that low doses of epidural pethidine were efficient on postoperative pelvic abdominal pain, but that doses should be increased if painless coughing was required.