Annales françaises d'anesthèsie et de rèanimation
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Ann Fr Anesth Reanim · Jan 1986
Randomized Controlled Trial Clinical Trial[Spinal anesthesia with bupivacaine for surgery of the hip in the elderly].
In 60 elderly patients, spinal anaesthesia for orthopaedic hip surgery was induced randomly with 15 mg bupivacaine 0.375% without glucose (Group I), 2.5% glucose (Group II) or 7.5% glucose (Group III), in 4 ml. The injection was made in the lateral position, and the patients turned supine immediately after. The onset, extent and duration of sensory and motor blockade, the cardiovascular effects and the quality of anaesthesia were evaluated. ⋯ It was suggested to take into account the more rapid infusion of lactated Ringer's solution (20 ml X kg-1) in Group III. Anaesthesia was satisfactory in 95% of patients in Group I and Group II, and 90% in Group III. Glucose-free bupivacaine produced a long-lasting blockade suitable for hip surgery of long duration.
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Ann Fr Anesth Reanim · Jan 1986
Comparative Study[Spinal anesthesia with isobaric 0.5% bupivacaine. Effect of age].
The effects of age on the characteristics of spinal anaesthesia with plain bupivacaine were investigated in 29 adult patients (less than 50 yr : group I), and 37 older patients (greater than or equal to 80 yr : group II). Three millilitres of 0.5% solution (15 mg) were injected at the L3-L4 interspace in the lateral position; the patients were turned supine immediately afterwards. The onset, extent and duration of sensory and motor blockade, the cardiovascular effects and the quality of anaesthesia were evaluated. ⋯ Only the Bromage's degrees 2 and 1 were greater in the elderly's group. In the older group, there was a tendency to a greater decrease in systolic arterial pressure from the preanaesthetic values (-20.9% versus -13%). But moderate falls in mean and diastolic arterial pressures were observed.(ABSTRACT TRUNCATED AT 250 WORDS)
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Ann Fr Anesth Reanim · Jan 1986
[Femoral nerve block as a postoperative analgesia technic in surgery of the knee].
A femoral nerve block was performed as a postoperative analgesic technique in 50 patients after knee surgery; this surgery is a very painful one. The technique used was the inguinal route, as described in the textbooks. ⋯ The average duration of analgesia was 600 min, the shortest being 300 min, the longest being 1,200 min. This technique can be recommended after surgery of the knee as safe and reliable.
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Ann Fr Anesth Reanim · Jan 1986
Randomized Controlled Trial Comparative Study Clinical Trial[Epidural anesthesia during labor: comparison of 3 combinations of fentanyl-bupivacaine and bupivacaine alone].
The association of bupivacaine and fentanyl appeared as the best method of inducing satisfactory obstetrical analgesia. But the various techniques of drug administration had to be detailed; this justified the present work, a single-blind controlled trial performed on 159 primipara women at term (except one of them), randomized in four groups, after informed consent. In each group, the number of patients, the age and the degree of uterine dilatation at the beginning of the epidural anaesthesia were comparable. ⋯ In the newborn, Apgar score was assessed at 1, 5 and 10 min after delivery. The degree of analgesia was statistically improved in the groups receiving fentanyl, without any differences between them. On the other hand, the length of labour was shorter with protocol II (lowest concentration of fentanyl).(ABSTRACT TRUNCATED AT 250 WORDS)
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Ann Fr Anesth Reanim · Jan 1986
Randomized Controlled Trial Comparative Study Clinical Trial[Comparative study of general and spinal anesthesia in elderly women in hip surgery].
The choice between regional versus general anaesthesia for elderly patients undergoing hip surgery is debated. It is vitally important to see if the type of anaesthetic administered affects per- and postoperative morbidity and mortality. Seventy women more than 75 yr old suitable for spinal anaesthesia were included in this study. ⋯ In patients having general anaesthesia, 22.9% developed bronchopneumonia as opposed to 8.6% in the spinal anaesthesia group (p less than 0.05). The mortality rate at three months was rather similar in the two groups. It was concluded that, in order to reduce the incidence of postoperative central dysfunction and bronchopneumonia, spinal anaesthesia should be preferred in geriatric patients for lower limb surgery.