Annales françaises d'anesthèsie et de rèanimation
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Ann Fr Anesth Reanim · Jan 1993
Non specific interactions in anti-agent IgE-RIA to anesthetic agents.
The sensitivity of usual IgE-RIA for detecting seric anti-neuromuscular blocking drug (NMBD) IgE antibodies is low. Our group and other authors have proposed quaternary ammonium compounds other than NMBD for the preparation of sepharose solid drug phase. These compounds cannot be cyclohexenyl derivatives in order to prevent hydrophobic interactions with seric hydrophobic IgE. ⋯ Such hydrophobic IgE are seen in 30% of atopic subjects, in 41% of patients with drug allergy and in 100% of those allergic to propofol. The latter had also anti-quaternary ammonium IgE in 5 out of the 8 cases studied. These NMBD antibodies could bind to the quaternary-ammonium ion of the lecithins from Diprivan micelles.
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Ann Fr Anesth Reanim · Jan 1993
Case Reports[Temporary relief from pain in the phantom limb after spinal anesthesia using a combination of bupivacaine and clonidine].
Two cases are reported of patients with phantom limb pain after lower limb amputation and requiring surgery of their stump. The stumps were revised and the remaining femoral shaft shortened. ⋯ The return of pain was preceded by the sensation of a phantom limb. These cases suggest that alpha 2 adrenergic agonists could play a major part in the treatment of phantom limb pain.
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Ann Fr Anesth Reanim · Jan 1993
Randomized Controlled Trial Comparative Study Clinical Trial[Infusion of propofol or closed-circuit isoflurane. A study of cost].
The choice of an anaesthetic agent is influenced by its cost. The use of a circle absorber system decreases the cost of the maintenance of anaesthesia with halogenated agents. Fast recovery and low incidence of postoperative nausea and vomiting are the main advantages of propofol. ⋯ The total cost of anaesthesia included also the recovery room stay. The mean duration of anaesthesia was not significantly different between the two groups (109.4 +/- 7.1 min vs 107.3 +/- 7.3 min group P vs group I). The delay lf recovery (eyes opening) was shorter in the propofol group (14.4 +/- 1.3 min vs 19.4 +/- 1.4 min) as well as the delay of discharge from the recovery room (70 +/- 4 min, vs 82.4 +/- 4.6 min).(ABSTRACT TRUNCATED AT 250 WORDS)
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Ann Fr Anesth Reanim · Jan 1993
Randomized Controlled Trial Comparative Study Clinical Trial[Analgesia after thoracotomy by extrapleural administration of continuous bupivacaine].
This study was aimed to assess the efficiency and the side effects of a continuous administration of bupivacaine into the paravertebral space. Twenty patients, ranked ASA 2 or 3, with a mean age of 57.9 years, and having had a posterolateral thoracotomy for resection of lung tissue, were randomly assigned to one of two groups, B or C. At the end of the surgical procedure, a 22 gauge catheter was inserted into the paravertebral extrapleural space, at T4 levels As soon as pain occurred during recovery (T0), the patients were given two-hourly intravenous boluses of buprenorphine. ⋯ In group B, plasma bupivacaine concentrations were measured throughout the infusion, and for an 8-hour period after its end. The statistical analysis included 15 patients only, as the catheter had moved into the chest cavity in the other 5. Analgesia was qualified to be adequate by all patients, but there was no statistically significant difference in the amounts of self-administered buprenorphine between groups B and C.(ABSTRACT TRUNCATED AT 250 WORDS)