Annales françaises d'anesthèsie et de rèanimation
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The pre-emptive analgesia concept suggests that pre-administration of analgesics may enhance the efficacy of these drugs. This review has selected the data from the literature according to two types of methodological criteria: Sackett's criteria, and those specific of pre-emptive analgesia studies. Infiltration, spinal and peripheral nerve blocks using local anaesthetic drugs do not seem to produce pre-emptive analgesia. ⋯ In other cases (NSAIDs, ketamine), pre-administration represents a change in usual practice. This is not justified for NSAIDs; NMDA receptor antagonists may offer an interesting research area. Data concerning pre-emptive analgesia for chronic pain syndrome such as phantom limb pain are quite limited.
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Ann Fr Anesth Reanim · Jan 1998
Case Reports-A difficult intubation of an infant with McKusick-Kaufman syndrome. Failure of the laryngeal mask-fibroscope sequence-.
Fibreoptic intubation through the laryngeal mask airway is a recommended technique for the management of a restricted airway. We report the failure of this technique in a 20-month-old infant presenting with McKusick-Kaufman syndrome.
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Ann Fr Anesth Reanim · Jan 1998
Comparative Study Clinical Trial[Continuous analgesia with a femoral catheter: plexus or femoral block?].
To evaluate the spread and quality of sensitive blockade produced by continuous and prolonged use of a femoral catheter inserted for postoperative analgesia. ⋯ In most patients, a local anaesthetic administered continuously via a femoral catheter produces a blockade limited to the femoral nerve. These data do not substantiate the conclusions by those who consider they are producing a continuous "3 in 1" block with this technique. However, it is obviously not essential to produce a sensitive blockade of the three main nerves of the lumbar plexus to obtain an effective analgesia after knee surgery.
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Subcutaneous emphysema associated with impossible tracheobronchial aspiration occurred in a patient several hours after percutaneous tracheostomy. Misplacement of tracheal cannula was diagnosed and a tube exchanger was used to replace the cannula in a normal position. Twenty hours later a tracheal tear was recognized. This paper considers the pathophysiology and prevention of such a complication.