Annales françaises d'anesthèsie et de rèanimation
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Ann Fr Anesth Reanim · Jan 1996
Comparative Study Clinical Trial[Combined spinal and epidural analgesia for labor. Prolongation by addition of a minidose of clonidine to sufentanil. An initial study].
The effect of adding a minidose of clonidine to intrathecal sufentanil during the early first stage of a painful labour was evaluated in this preliminary open-label, non-randomised trial. Group 1 received sufentanil 5 micrograms + clonidine 30 micrograms intrathecally (n = 10) and group 2 only intrathecal sufentanil 5 micrograms (n = 11). The two groups were not statistically different regard-ing age, weight, height, primiparity (67 vs 50%), oxytocin use (37 vs 60%), initial cervical dilation (m +/- DS: 2.9 +/- 1.1 vs 2.9 +/- 1 cm) and VAS pain scores (70 +/- 14 vs 68 +/- 19 mm). ⋯ Side effects, such as hypotension, pruritus and sedation, were not statistically different between groups. Nausea and motor blockade did not occur. In conclusion, the addition of a minidose (30 micrograms) of clonidine to sufentanil 5 micrograms given intrathecally seems to potentiate markedly the analgesia obtained during the early first stage of labour.
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Ann Fr Anesth Reanim · Jan 1996
Multicenter Study[Anesthesia and intensive care of subarachnoid hemorrhage. A survey on practice in 32 centres].
To assess the current practices in anaesthesia and intensive care in patients experiencing subarachnoid haemorrhage (SAH). ⋯ Twenty-nine French and three non French centers answered the questionnaire. In 14 centers, more than 60 SAH had been treated in the previous year. Angiography was performed under sedation with a benzodiazepine associated with an opioid (54%). Criteria for choosing an endovascular approach were the site of the aneurysm (81%), its neck size (42%) and the underlying disease (42%). Anaesthesia was induced with either propofol (60%) or thiopentone (40%) associated with an opioid and a muscle relaxant. It was maintained with either isoflurane (59%) or propofol (41%). Nitrous oxide was often associated (62%). During anaesthesia, nimodipine (84%), mannitol (69%), anticonvulsants (47%), dopamine (31%) and lidocaine (9%) were also administered. Postoperatively, nimodipine was administered for prophylaxis of vasospasm (97%) and transcranial Doppler was employed to diagnose vasospasm (50%). Other techniques of care included hypervolaemia (89%), controlled arterial hypertension (36%) and haemodilution (36%).
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Ann Fr Anesth Reanim · Jan 1996
Comparative Study[Delay of clinical recovery from paralysis induced by atracurium: comparison between orbicularis oculi and adductor pollicis].
To compare with train-of-four stimulation the delays of the beginning of the spontaneous recovery of the orbicularis oculi and of the adductor pollicis after profound neuromuscular blockade with atracurium. ⋯ The orbicularis oculi should not be monitored alone for assessment of recovery from profound neuromuscular blockade by atracurium, as it predicts poorly the time of the recovery of the adductor pollicis.
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Ann Fr Anesth Reanim · Jan 1996
Comparative Study[Evaluation of cognitive functions after anesthesia with propofol].
To assess the disturbances and delay of recovery of cognitive functions following propofol anaesthesia, and to evaluate a series of simple cognitive recovery tests. ⋯ Complete recovery can be evaluated by simple cognitive tests, which showed that cognitive functions are impaired over a longer period than psychomotor functions. Oral instructions may therefore not be fully understood by the patient within 3 hours after anaesthesia, emphasizing the importance of written instructions and the essential role played by a well-informed accompanying person.
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Ann Fr Anesth Reanim · Jan 1996
[Claims related to anesthesia at the University Hospitals of Paris].
To evaluate the number and the reason of anaesthesia-related malpractice claims in university hospitals of Paris. ⋯ There are few anaesthesia-related claims in the Paris university hospitals. Only few claims result in a compensation. By contrast, when a indemnification is alloted, its amount is very high. Locoregional anaesthesia seems to be at a higher risk for malpractice claims.