Annales françaises d'anesthèsie et de rèanimation
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Ann Fr Anesth Reanim · Jan 1998
Case Reports-Coagulopathy suggestive of a primary fibrinolysis after head injuries with brain death-.
Coagulopathies associated with severe head trauma are usually of disseminated intravascular coagulation type with secondary fibrinolysis. We report a case whose semeiology was in part suggestive of a primary fibrinolysis.
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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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To evaluate the incidence and the causes of early intra- and postoperative deaths in a multidisciplinary hospital. ⋯ In this survey, mortality due to anaesthesia was higher than the rates reported in other studies. Human error remained the main cause.
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Ann Fr Anesth Reanim · Jan 1998
Case Reports[Motor deficit of the lower limbs and urinary incontinence following peridural anesthesia].
Neurological complications of epidural anaesthesia are rare, but can be severe. We report the case of a 49-year-old man, with a history of non equilibrated diabetes, who experienced after an epidural anaesthesia for peripheral vascular surgery a polyneuropathy with muscle weakness of the lower extremities associated with a transient urinary incontinence. ⋯ An aggravation of a pre-existing diabetic and alcoholic polyneuropathy, associated with possible spinal ischaemia of multifactorial origin could be the cause of these complications. This case emphasizes the importance, during preanesthetic assessment of candidates for epidural or spinal anaesthesia, to search for a possible unrecognized neuropathy at risk of aggravation by regional anaesthesia.