Annales françaises d'anesthèsie et de rèanimation
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Ann Fr Anesth Reanim · Jan 1996
Randomized Controlled Trial Comparative Study Clinical Trial[Gynecologic laparoscopy with or without curare].
To assess physiological changes and operating conditions during general anaesthesia with or without neuromuscular blockade in patients undergoing gynaecologic laparoscopy. ⋯ Neuromuscular blockade influences neither most of the clinical haemodynamic and respiratory changes induced by pneumoperitoneum for gynaecologic laparoscopy not the operating conditions.
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A 60-year-old man, was admitted in the emergency ward, following a motor vehicle accident. At the time of arrival his clinical state was stable. The initial investigations showed a moderate left haemopneumothorax and fractured ribs. ⋯ An emergency thoracotomy was performed which showed a right ventricular perforation by a rib fragment. The authors discuss the role of possible changes in heart position produced by induction of general anaesthesia. Indeed the decrease in functional residual capacity following induction of anaesthesia with a cephalad diaphragmatic shift may have secondarily exposed the right ventricle to the bevel of a fractured rib.
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Ann Fr Anesth Reanim · Jan 1996
[Blood loss from diagnostic laboratory tests performed in intensive care units. Preliminary study].
To assess the volume of blood samples withdrawn for laboratory testing in intensive care unit (ICU) patients and to determine the influence of the resulting blood loss on transfusion requirements in patients staying in the ICU for more than seven days. ⋯ Blood losses from blood withdrawal for laboratory tests are important and in agreement with the results of other reports. It is generally accepted that iatrogenic blood loss of this magnitude can cause anaemia if repeated over a prolonged period. Conversely, our data suggest that blood sampling does not contribute significantly to anaemia and transfusion requirements in patients with a prolonged ICU stay.
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Human albumin is available either as a 4 or a 20% solution. Only the latter is a plasma expander which increases volaemia by an amount corresponding to the four-fold of the infused volume. ⋯ Therefore, when the administration of albumin is indicated, the 20% solution should be preferred, as well as for volume expansion as for other uses, due to a decreased sodium load. However, this recommendation has not been substantiated by comparative studies.
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Ann Fr Anesth Reanim · Jan 1996
Case Reports[Cancer pain: beneficial effect of ketamine addition to spinal administration of morphine-clonidine-lidocaine mixture].
To assess the benefit of ketamine addition to a morphine-clonidine-lidocaine mixture administered continuously by the intrathecal route for the treatment of cancer pain. ⋯ Ketamine by intrathecal route potentiates analgesia obtained with morphine-clonidine and lidocaine, while impeding the development of a tolerance vis-à-vis the former.