Annales françaises d'anesthèsie et de rèanimation
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Ann Fr Anesth Reanim · Jan 1995
Randomized Controlled Trial Comparative Study Clinical Trial[Endotracheal intubation under propofol with or without vecuronium].
In order to test the hypothesis that under the association propofol-alfentanil-IV lidocaine the trachea could be intubated easily without an additional muscle relaxant, this study compared the intubation conditions when this association was combined or not with vecuronium. ⋯ In young healthy adults, without anaesthetic risk (emergency, full stomach) and without foreseen difficult intubation, the endotracheal tube can be inserted in convenient conditions without a muscle relaxant, under the association propofol-alfentanil-lidocaine iv.
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Ann Fr Anesth Reanim · Jan 1995
[Combination of propofol-sufentanil on somatosensory evoked potentials in surgery of the spine].
Most anaesthetics depress cortical somatosensory evoked potentials (CSEPs). However, the modification of CSEPs during total intravenous anaesthesia using propofol remaining still unknown, justified this trial. ⋯ Total intravenous anaesthesia with propofol and sufentanil induces a small but stable lengthening of CSEPs latency and a stable decrease of its amplitude, which enable an appropriate monitoring of CSEPs during spine surgery.
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Ann Fr Anesth Reanim · Jan 1995
[Cervicofacial cellulitis of dental origin and tracheal intubation].
To evaluate the difficulty of intubation in relation with the localisation and spread of cervico-facial cellulitis of odontogenic origin and to recognize the optimal technique of intubation in such circumstances. ⋯ The localisation of cellulitis of odontogenic origin is responsible for the difficulty grade of intubation. Awake fibreoptic intubation should be systematically performed in patients with a floor of the mouth cellulitis to reduce the risk of rupture of the abscess by a laryngoscope blade. As trismus associated with mandibular localisations is not relieved by general anaesthesia, awake fibreoptic endotracheal intubation should be preferred.
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Ann Fr Anesth Reanim · Jan 1995
Case Reports[Prolonged neuromuscular block induced by mivacurium in a patient treated with cyclophosphamide].
A case is reported of prolonged neuromuscular block after mivacurium chloride for laparoscopic cholecystectomy, in a 45 years old patient, treated with cyclophosphamide for a Wegener's granulomatosis. The neuromuscular function monitoring by train-of-four showed a duration of action of 75 min after an intubation dose of 0.20 mg.kg-1. Additional bolus of 1 mg, corresponding to 25% of usual doses, every 10 or 15 min, were sufficient for maintaining muscle relaxation. ⋯ Plasma butyrilcholinesterases activity were reduced to a level of 50%. With reference to literature about succinylcholine, the responsibility of cyclophosphamide is likely, and discussed. This observation shows the value of monitoring the neuromuscular transmission.
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Quantitative and qualitative nutritional requirements depend on the level of energetic expenses. Various formulas, especially the tables by Harris and Benedict allow the estimation of the level of energetic expenses with an approximation of 14%. Corrective factors permit an adjustment of the figures, according to the level of body aggression. ⋯ Biological monitoring includes the electrolyte balance and various variables of carbohydrate, lipidic and proteic metabolisms. It allows to check the absence of hyperglycaemia, hyperlipidaemia and cholestasis. The daily checking of catheters is part of the monitoring of nutritional support.(ABSTRACT TRUNCATED AT 250 WORDS)