Annales françaises d'anesthèsie et de rèanimation
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A case is reported of acute fatty liver of pregnancy with maternal and foetal survival inspite of jaundice, encephalopathy, renal failure, gastro-intestinal haemorrhage and serious coagulation problems. The acute fatty liver is a rare disease of unknown aetiology which occurs during the third trimester of pregnancy. Early diagnosis based on liver biopsy obtained by the transjugular route, immediate delivery of the foetus and intensive care improve an otherwise fatal prognosis.
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Ann Fr Anesth Reanim · Jan 1986
[Sciatic nerve block by the anterior approach in surgery of the legs].
Forty-four sciatic nerve blocks were performed by the anterior route in combination with forty-four "3-in-1" blocks and seven lateral femoral cutaneous nerve blocks. The use of radioscopy for determining the anatomic injection points made the technique easier and safer. It was preferred for patients in whom general anaesthesia was not desirable for lower limb surgery.
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Ann Fr Anesth Reanim · Jan 1986
[French survey on anesthesia systems and peroperative respiratory monitoring equipment].
A national inquiry has been carried out in France. It concerned the anaesthetic systems and respiratory monitoring equipment in use at the moment, as well as that wished for. The equipment in use was very stereotyped: an open system with a respirator, for the most volumetric, and with a safety O2/N2O mixer. ⋯ The big centres and the teaching hospitals were interested by the expiratory CO2 monitoring. This inquiry showed the interest in respiratory safety in operating theatres. Further studies should confirm or not the increasing interest in closed systems.
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Ann Fr Anesth Reanim · Jan 1986
[Plasma determination of lidocaine and bupivacaine after caudal anesthesia in children].
Serum concentrations of lidocaine and plasma concentrations of bupivacaine were measured so as to assess the risk of systemic toxicity following their administration by the caudal route in children, and study their pharmacokinetic profiles according to age. The serum concentrations of lidocaine were measured by immuno-enzymology in 37 children (23 +/- 13 kg) during the first hour after administration of 7 mg . kg-1. The plasma concentrations of bupivacaine were measured by high performance liquid chromatography in 40 children (18.03 +/- 8.90 kg) during the first hour after administration of 2.5 mg . kg-1. ⋯ Higher values were observed in infants weighing less than 12 kg where they reached 2.89 +/- 0.72 and 1.52 +/- 0.68 micrograms . ml-1 respectively. These results showed that caudal anaesthesia with lidocaine (7 ml . kg-1) and bupivacaine (2.5 ml . kg-1) was a safe technique for children, giving average plasma concentrations inferior to toxic values. However, it seemed prudent not to give more than the prescribed doses in the small infant.
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Ann Fr Anesth Reanim · Jan 1986
Case Reports[Examination of the family of a patient susceptible to anesthetic malignant hyperthermia].
The familial nature of anaesthetic malignant hyperthermia must lead to the search for susceptibility in other members of the family of a sensitive subject. According to the literature, only in vitro studies of contraction characteristics of biopsied skeletal muscle fibres exposed to caffeine or halothane are of predictive value. Four members of the family of a patient who died as a result of malignant hyperthermia were investigated. The results expressed in accordance with the criteria defined by the European group on malignant hyperthermia, coupled with a histoenzymatic study, defined three of the subjects as HMN (negative) and one subject as HM (c) (equivocal or intermediate).