Annales françaises d'anesthèsie et de rèanimation
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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 Clinical Trial[Prevention of increase of blood pressure and intracranial pressure during endotracheal intubation in neurosurgery: esmolol versus lidocaine].
To compare the preventive effects of esmolol and lidocaine on the increase in mean arterial pressure (MAP) and intracranial pressure (ICP) during endotracheal intubation in neurosurgery. ⋯ Esmolol or lidocaine as an iv bolus of 1.5 mg.kg-1 before laryngoscopy and intubation do not completely prevent the increase in MAP and ICP.
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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
Comparative Study[Changes in intraocular pressure during anesthesia with intratracheal intubation or laryngeal mask].
To compare the effects of the laryngeal mask airway (LMA), and the tracheal tube (TT) insertion on intra-ocular pressure (IOP) in eye surgery. ⋯ LMA insertion does not elicit significant haemodynamic or IOP changes. Conversely, the TT increases HR, MAP and IOP. These changes can be deleterious in case of emergency surgery for perforating eye injuries. The LMA can be recommended as an alternative to TT in eye surgery, provided security rules are followed, because of the risk of displacement of LMA during surgery.
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Ann Fr Anesth Reanim · Jan 1996
Practice Guideline Guideline[Difficult intubation. French Society of Anesthesia and Intensive Care. A collective expertise].