Annales françaises d'anesthèsie et de rèanimation
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Ann Fr Anesth Reanim · Jan 1991
Randomized Controlled Trial Clinical Trial[Effects of intravenous clonidine on postoperative shivering].
A study was designed to assess the possible effects of intravenous clonidine on postoperative shivering. Fifty patients undergoing spinal fusion under isoflurane anaesthesia were randomly assigned to two groups (n = 25). Patients in one group were given intravenous clonidine (5 micrograms.kg-1 during the first hour, and 0.3 microgram.kg-1.h-1 thereafter) or placebo. ⋯ Clonidine significantly decreased blood pressure, heart rate, cardiac output and whole body oxygen consumption. The patients in these series were free from any cardiac disease. Further studies are required to assess the possible beneficial effects of clonidine on postoperative oxygen consumption in patients suffering from heart failure.
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Ann Fr Anesth Reanim · Jan 1991
Randomized Controlled Trial Comparative Study Clinical Trial[Controlled trial of a non-invasive continuous blood pressure monitor: Cortronic AMP 770].
The performances of a Cortronic AMP 770 monitor, a new apparatus for non invasive continuous blood pressure monitoring was assessed. Its working principle is derived from oscillometry. The blood pressure cuff is kept at a low pressure (about 20 mmHg), and the oscillations induced by the arterial pulse are converted into blood pressure. ⋯ There was no correlation between blood pressure levels and discrepancy in the measurements obtained with the two methods. The Cortronic AMP 770 was reliable under normal circumstances, when compared with a traditional oscillometer. However further studies are required to assess its reliability under pathological circumstances (severe hypotension or hypertension, arrhythmias and sudden changes in blood pressure).
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Ann Fr Anesth Reanim · Jan 1991
Review Case Reports[Iterative epidural anesthesia after accidental dural puncture. Analysis with epidurography].
The case is reported of a 63-year-old man who was to undergo a gastrectomy for stomach carcinoma. An epidural catheter for postoperative analgesia (epidural morphine) was inserted into the T10-11 space prior to induction of general anaesthesia. Unfortunately, cerebrospinal fluid (CSF) surged back through the Tuohy needle, which was immediately withdrawn. ⋯ Another epidurography, 24 hours later, showed the same picture. The analgesic technique was therefore altered to subcutaneous buprenorphine. Careful management of this situation, in order to prevent total spinal anaesthesia, is discussed in the light of the literature.
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A 37-year-old chronic alcoholic female was admitted with epigastric pain, complete anorexia, vomiting and diarrhoea. She was dehydrated, and had polypnoea. Laboratory investigations revealed severe metabolic acidosis (pH 7.14) with a major anion gap (37.4 mmol.l-1), and ketone bodies in blood and urine. ⋯ The ketone bodies disappeared on the following day. During the acute illness, were found high blood levels of glucagon and low levels of insulin. The diagnosis of alcoholic ketoacidosis, the pathogenesis of which remains unknown, is discussed.
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Ann Fr Anesth Reanim · Jan 1991
Review[Incidence and etiology of cardiac arrest occurring during the peroperative period and in the recovery room. Apropos of 102,468 anesthesia cases].
This study reviewed retrospectively 186 cardiac arrests (CA) observed in a series of 102,468 anaesthetics, carried out in a University Hospital between 1983 and 1987. Among them 29 were partly or totally related to anaesthesia and 11 had a fatal outcome. On the other hand, 157 CA (144 deaths) were not related to anaesthesia. ⋯ Outcome was independent of ASA class, but was related to aetiology: hypoxaemia (5 out of 6 recovered) and overdose with or without hypovolaemia (7 out of 8 recovered) had favourable outcomes. Furthermore, outcome of CA due to regional anaesthesia was satisfactory (7/8 recovered) (p = 0.08, NS). Such an analysis of the causes of anaesthetic disasters and their rate of occurrence can lead to more effective prevention.