Annales françaises d'anesthèsie et de rèanimation
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Ann Fr Anesth Reanim · Jan 1993
[Monitoring of hemostasis during liver transplantation: contribution of thromboelastography].
Monitoring of coagulation is mandatory during liver transplantation (LT). Standard coagulation tests may be routinely used. However, they give static information and may be inadequate in case of severe coagulation defect. ⋯ Twelve of them had a CLI value reaching 0%, associated with severe generalized oozing. Aprotinin (200,000 to 600,000 KIU) corrected these abnormalities. These results show that TEG may not be very helpful to determine whether platelets or fibrinogen are involved in the phase of hypocoagulability detected after unclamping.(ABSTRACT TRUNCATED AT 250 WORDS)
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Ann Fr Anesth Reanim · Jan 1993
Case Reports[Cesarean section, mitral valve disease and pulmonary hypertension. Implications of hemodynamic monitoring on anesthetic management].
We present the case of a 25-year-old woman with mitral valve disease and severe pulmonary hypertension scheduled for Caesarean section under general anaesthesia. General anaesthesia for such cardiac patients requires usually high doses of fentanyl prior to intubation, which favours maternal inhalation and neonatal ventilatory depression. Invasive haemodynamic monitoring allowed a rapid sequence induction, with an optimal drug titration and an early recovery.
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Ann Fr Anesth Reanim · Jan 1993
Case Reports[Tetraplegia after colonoscopy: benzodiazepine withdrawal syndrome induced by flumazenil?].
A case is reported of a 68-year-old female patient who developed a flaccid tetraplegia on recovering from a colonoscopy, carried out under general anaesthesia (3 mg of midazolam, 20 mg of etomidate). During the preanaesthetic visit, she omitted to report a 15-year-addiction to lorazepam 2.5 mg every night. At the end of the procedure, 0.2 mg of flumazenil were injected. ⋯ She was discharged the same day but complained of myalgia and paraesthesia for a week. The physiopathology of this accident is unknown. The differential diagnosis and the influence of flumazenil on benzodiazepine withdrawal are discussed.
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Ann Fr Anesth Reanim · Jan 1993
Case Reports[Cerebral pneumocephalus after epidural anesthesia: a rare complication?].
A case is reported of pneumoencephalus occurring after an accidental dural puncture during a cervical epidural puncture using the loss of resistance technique. Six ml of air were injected intrathecally. ⋯ It may be difficult to differentiate between headache due to pneumoencephalus and that by stretching of the meninges due to cerebrospinal fluid leakage. Only a CT scan can help to answer this question.