Annales françaises d'anesthèsie et de rèanimation
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Ann Fr Anesth Reanim · Jan 1996
Randomized Controlled Trial Comparative Study Clinical Trial[Comparative study of buprenorphine and its combination to ketoprofen or propacetamol for postoperative analgesia in urologic surgery].
To compare the analgesic effect of subcutaneous buprenorphine alone and in combination with propacetamol and ketoprofen following urologic surgery. ⋯ A combination of buprenorphine, propacetamol and ketoprofen provides effective postoperative analgesia with a low incidence of nausea and vomiting and decreased requirements of buprenorphine.
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Spinal anaesthetics can induce histopathologic lesions and regional haemodynamic alterations in the spinal cord. There are numerous causes of neurologic lesions, including direct trauma of the spinal cord and nerve roots during puncture or catheter insertion, compromised spinal cord perfusion and direct neurotoxic effect. Histopathologic lesions are localized either in meninges (meningitis or arachnoiditis) or in neuraxis (myelitis or axonal degeneration). ⋯ Incomplete blockade should not necessarily lead to a reinjection. Large volume of hyperbaric lidocaine or repeated injections of such solutions must be avoided as well as preservative-containing solutions. The administration of new compounds by the spinal route must be supported by data of spinal neuropharmacology and the lack of neurotoxicity must have been previously checked with animal studies.
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Ann Fr Anesth Reanim · Jan 1996
Randomized Controlled Trial Comparative Study Clinical Trial[Analgesia after laparoscopic cholecystectomy by intraperitoneal administration of bupivacaine].
The aims of this study were to assess the analgesic effect of the intraperitoneal topical administration of 0.375% bupivacaine in patients undergoing laparoscopic cholecystectomy and to carry out a pharmacokinetic study of bupivacaine administered topically by intraperitoneal route. ⋯ Intraperitoneal administration of 0.6 mL.kg-1 of 0.375% bupivacaine is ineffective in reducing postoperative pain after laparoscopic cholecystectomy. Furthermore these high doses of bupivacaine may result in toxic plasma concentrations. This technique is not safe and cannot be recommended.
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Ann Fr Anesth Reanim · Jan 1996
Randomized Controlled Trial Comparative Study Clinical Trial[Intubation conditions: importance of the rate of repetition of the train-of-four].
To assess that neuromuscular relaxation onset of the adductor pollicis (AP) is related to neuromuscular stimulation rate. To assess that train-of-four (TOF) at 0.05 Hz is a more accurate indicator of optimal tracheal intubation time and conditions, than TOF at 0.08 Hz. ⋯ Low stimulation rate (TOF at 0.05 Hz) of AP is a reliable technique to determine the appropriate intubation time for patients paralyzed with vecuronium.
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Ann Fr Anesth Reanim · Jan 1996
Review[Indications and role of albumin for vascular loading during postoperative intensive care].
Prospective clinical trials comparing human albumin to other plasma volume expanders during the three first postoperative days in adult patients were analysed. Fifteen studies were selected. Nine of them concerned the evaluation during the immediate postoperative period, after cardiac surgery with cardiopulmonary bypass (CPB). ⋯ After cardiac surgery, mainly uncomplicated coronary artery bypass graft or valve replacement, albumin can be substituted by HES. These conclusions are only valid for blood losses below 50% of blood volume. The place of isooncotic albumin for fluid resuscitation in case of blood loss exceeding 50% of blood volume cannot be specified.