Annales françaises d'anesthèsie et de rèanimation
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Ann Fr Anesth Reanim · Jan 1995
Case Reports[Cephalic cancer pain controlled by intraventricular administration of morphine and clonidine].
A 47-year-old woman suffered from a pharyngeal cancer causing pain only poorly relieved by high doses of oral morphine. Oral administration was switched to the intracerebroventricular (ICV) route but pain relief was only transient despite a daily dosage up to 1.5 mg of morphine. Finally an effective pain relief was achieved with increasing doses of clonidine (5 to 30 micrograms) in combination with morphine (1.5 mg) by ICV route. Neither arterial hypotension nor sedation occurred and the patient recovered transiently a better quality of life.
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Ann Fr Anesth Reanim · Jan 1995
Case Reports[A cause of difficult weaning from artificial respiration: polyneuropathy of intensive care].
Three cases of Critically Illness Polyneuropathy (CIP) are reported. The difficulty of weaning the patients from the ventilator, whereas sepsis and MOF had been successfully treated, was the main feature in the three cases. The diagnosis was established by eletromyogram, showing a primary axonal denervation of peripheral nerve fibres, which was confirmed by a pathological study in one patient.
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Ann Fr Anesth Reanim · Jan 1995
Practice Guideline Guideline[How to assess preoperative nutritional status?].
The assessment of nutritional status of patients should rely on sensitive and specific evaluation tools. However a universally recognized criterion of severity of denutrition is still lacking. The most important clinical indicator is the weight. ⋯ The determination of body mass composition by bioelectrical impedance could become the technique of choice for nutritional assessment. However its use for peri-operative evaluation has not been validated prospectively. Because of the lack of reliability of markers when considered alone, several authors produced multivariate nutritional indices.(ABSTRACT TRUNCATED AT 250 WORDS)
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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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Ann Fr Anesth Reanim · Jan 1995
[Ventilators for anesthesia. Models available in France. Criteria for choice].
This update article discusses the criteria for the choice of an anaesthetic machine and provides a short analysis of the main components of the models commercialized in France in 1994. The following items are considered: the design of the machine, the fresh gas delivery system, the anaesthesia breathing system(s), the ventilator and the waste gas scavenging system, the monitors associated with the machine and other criteria such as facility of learning to run the machine and of its daily use, ease of "in-house" maintenance and quality of after-sales service, cost of the machine and of its use (driving gas, disposable equipment).