Annales françaises d'anesthèsie et de rèanimation
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Ann Fr Anesth Reanim · Jan 1998
[Evaluation of training on intubation with a rigid fiber optic laryngoscope (UpsherScope)].
To evaluate the learning of tracheal intubation with a new rigid fibreoptic laryngoscope (UpsherScope). ⋯ The UpsherScope, a new rigid fibreoptic laryngoscope devised for routine and difficult intubation, is robust and allows the view of the tracheal tube passing between the vocal cords. However, in this study the intubation success rate remained low and was not improved by further experience. No benefit was found with the UpsherScope in patients with normal airways. Further studies are necessary to assess its efficiency in cases of difficult intubation.
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Ann Fr Anesth Reanim · Jan 1998
Case Reports[Total spinal anesthesia after posterior lumbar plexus block].
We report a case of total spinal anaesthesia which occurred after a lumbar plexus block using a posterior approach. After total hip arthroplasty under general anaesthesia, a lumbar plexus block was performed according to Winnie's landmarks at the L4 interspace using a nerve stimulator. ⋯ One minute after the injection of 27 mL of the same mixture, a complete anaesthetic block occurred with hypotension and loss of consciousness requiring intubation and controlled ventilation during 3h30, without sequelae. Lumbar plexus block using a posterior approach must be performed cautiously and a slow and fractionated injection of the full dose is recommended.
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Ann Fr Anesth Reanim · Jan 1998
Clinical Trial[Noninvasive postoperative ventilation using a buccal mask].
In this preliminary study we assessed the feasibility and efficiency of non-invasive ventilation (NIV) with a buccal mask (NIV-BM), not fitted with a mouthpiece, in surgical patients in acute respiratory failure whose lungs could not be ventilated with a face mask. In the eight patients enrolled in the study, NIV-BM increased tidal volume, decreased respiratory rate and improved PaO2. In two patients the trachea had to be intubated and one of them died of septic shock. NIV-BM can act as a valuable alternative in surgical patients in acute respiratory failure in whom a face mask cannot be used because of leaks or bad tolerance.
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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.