Annales françaises d'anesthèsie et de rèanimation
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Ann Fr Anesth Reanim · Jan 1998
Editorial Comment[Infections and the practice of anesthesia and recovery].
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To review current data on butyrylcholinesterase. ⋯ Butyrylcholinesterase must be differentiated from acetylcholinesterase, which cannot hydrolyse succinylcholine. The physiological action of butyrylcholinesterase remains unknown, although it can hydrolyse many drugs. Excluding genetical mutations, several physiopathological situations alter butyryl-cholinesterase activity. Butyrylcholinesterase activity assessment does not allow the diagnosis of genetic variants. Whatever the origin, only deficits of more than 50% modify significantly the metabolism of succinylcholine or mivacurium. The diagnosis of a prolonged neuromuscular blockade is obtained with systematic monitoring of the neuromuscular function in case of administration of mivacurium or succinylcholine. Mivacurium should only be re-injected when one response at train of four is obtained. In case of prolonged neuromuscular blockade, the anticholinesterasic agent should not be administered when no response at train of four is obtained. The biochemical methods using inhibitors (dibucaine, fluoride) of the butyrylcholinesterase and a familial study lead to the diagnosis in most cases because the atypical and fluoride variants are the most frequent. When results are doubtful, genetic molecular methods with the use of PCR and restriction enzymes allow a rapid diagnosis.
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Ann Fr Anesth Reanim · Jan 1998
Randomized Controlled Trial Comparative Study Clinical Trial[Analgesia using continuous axillary block after surgery of severe hand injuries: self-administration versus continuous injection].
To compare analgesia produced after surgery for severe hand trauma, by a continuous axillary block obtained either with a continuous injection (CA) or controlled by the patient (PCA). ⋯ Continuous axillary plexus blockade provides safe and effective postoperative analgesia. With the PCA technique results a lower quantity of bupivacaine is required and patient's satisfaction better.
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Ann Fr Anesth Reanim · Jan 1998
Randomized Controlled Trial Comparative Study Clinical Trial-The effect of ondansetron on intracranial pressure and cerebral perfusion pressure in neurosurgical patients-.
To determine the effect of ondansetron on intracranial pressure (ICP), mean arterial pressure (MAP) and cerebral perfusion pressure (CPP). ⋯ Intravenous administration of 8 mg ondansetron affects neither cerebral hemodynamics nor ICP.
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Ann Fr Anesth Reanim · Jan 1998
Review[Benefit-risk and monitoring modalities of different techniques and methods of postoperative analgesia].
This review aimed to determine the benefits-risks ratio of postoperative analgesia. The various agents usually used for intravenous postoperative analgesia (paracetamol, NSAID's, opioids), and the techniques for postoperative analgesia (PCA, epidural, perinervous block) are analysed. The rules proposed for the monitoring of postoperative analgesia are considered.