Annales françaises d'anesthèsie et de rèanimation
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Ann Fr Anesth Reanim · Jan 1998
Comparative Study-Anesthesia and analgesia practice patterns in French obstetrical patients-.
To assess the rate of epidural analgesia (EA) for parturition and the techniques of anaesthesia for Caesarean section (CS). ⋯ In France in 1991, the average rate of 37.2% for EA for obstetrics was high when compared to the rate in United Kingdom. It was equivalent to those in United States and Ontario, Canada. The discrepancies between hospitals were mainly related to structural and organizational factors. The influence of the size of the maternity hospital, the 24-hour service of EA was also shown in other studies. However, the difference between GA and UH and PH is a French particularity. The high rate of GA for CS differs largely with those in the UK or the USA. The time saving aspect of GA was probably an important factor for the choice of this technique. This study must be reactualized and enlarged to determine the demand of EA for labour by parturients and obstetricians.
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Ann Fr Anesth Reanim · Jan 1998
[Pressure-controlled mechanical ventilation: a simplified titration method of the extrinsic positive expiratory pressure].
Extrinsic positive end-expiratory pressure (PEEPe) may improve gas distribution within the lungs, induce alveolar recruitment or, conversely, produce pulmonary overdistension, and modify the respiratory impedance. Under pressure-controlled mechanical ventilation (PCV) this phenomenon modifies the minute ventilation and the dynamic compliance of the respiratory system (Crs,dyn). This study was aimed to assess the incidence of a significant gain in Crs,dyn under the effect of PEEPe during PCV. ⋯ In 50% of the studied patients a significant gain in Crs,dyn was found, allowing a less traumatic PCV. These results suggest the clinical usefulness of this method of titration of PEEPe, which requires neither specific devices nor a disconnection of the patient.
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Ann Fr Anesth Reanim · Jan 1998
[Halogenated anesthetic vaporizers: importance of maintenance regulations].
We report a serious dysfunction of 19 halothane vaporisers Vapor 19.3 (Dräger) which delivered a much higher concentration of agent than indicated on the dial. This inaccuracy was linked to a major corrosion of the inner layers of the vaporiser, with a deposit of zinc bromide and chloride in the bypass channel. The main cause for this dysfunction was the absence of an adequate maintenance of the vaporisers since their purchase 3 years before.
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Ann Fr Anesth Reanim · Jan 1998
Review[Frequency, intensity, development and repercussions of postoperative pain as a function of the type of surgery].
Type of surgery is the most important factor conditioning intensity and duration of postoperative pain. Thoracic and spinal surgery are the most painful procedures. Abdominal, urologic and orthopedic surgery lead to severe postoperative pain. ⋯ The surgical procedure is the major determinant of metabolic and psychologic postoperative deterioration. Adequate pain relief allows postoperative rehabilitation and physiotherapy programmes after abdominal and orthopaedic surgery. This could be expected to reduce hospital stay and improve convalescence.