Annales françaises d'anesthèsie et de rèanimation
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To review pharmacology and therapeutic use of propacetamol, an injectable prodrug of acetaminophen (paracetamol). ⋯ Mechanisms of action of paracetamol differ from those of NSAIDs, giving account of a low risk of adverse renal, gastrointestinal and haematological effects. Thanks to their high therapeutic index, prescription of propacetamol and paracetamol is quite simple and safe. Main indications of both drugs are painful conditions, especially but not exclusively in the postoperative period, not requiring opioids and also in combination with other analgesic drug and/or techniques (balanced or multimodal analgesia). Because of cost, IV propacetamol is changed for oral paracetamol as soon as possible.
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To analyse current data on use of neuromuscular blocking agents (NBA) in the intensive therapy unit (ITU) patients and to propose practice guidelines. ⋯ The use of NBA in ITU patient should result from a rational decision making procedure, the blockade titrated with a TOF monitor and maintained as superficially and shortly as possible.
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Ann Fr Anesth Reanim · Mar 1999
Clinical Trial[Learning placement of a new oropharyngeal intubation (Copa)].
To assess learning of Copa (cuffed oropharyngeal airway) technique required for insertion and manual ventilation. ⋯ Copa is easy to use without previous training. Further studies are required to assess its side effects and the appropriate depth of anaesthesia required for its insertion.
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To assess the incidence and the causes of failures of anaesthesia machines. ⋯ This study emphasizes the value of the check-list and the failure report. The presence of a specially trained anaesthetic nurse allows immediate correction of the majority of technical problems.
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To analyse the various methods for carbon dioxide absorption in anaesthesia, the available absorbents and their modes of use. ⋯ Carbon dioxide absorption enables the use of low flow anaesthesia, and a decreased consumption of medical gases and halogenated anaesthetics, as well as reduced pollution. Chemical absorbents (soda-lime and barium hydroxide lime (Baralyme) may produce toxic compounds: carbon monoxide with all halogenated anaesthetics and compound A with sevoflurane. Simple measures against desiccation of the lime prevent carbon monoxide production. The toxicity of compound A, shown in the rat, has not been proven in clinical anaesthesia. Recent improvements in manufacture processes have decreased the powdering of lime. Moreover, filters inserted between the anaesthesia circuit and the patient abolish the risk for powder inhalation.