Annales françaises d'anesthèsie et de rèanimation
-
Ann Fr Anesth Reanim · Oct 2002
Case Reports[Chest pain and sulprostone during postpartum hemorrhage].
A case of chest pain in a 31-year-old woman after vaginal delivery with epidural analgesia during sulprostone administration is described. Chest pain occurred shortly after sulprostone was started and disappeared when sulprostone was stopped. Ischaemia related data were negative. ⋯ Sulprostone pharmacology is summarized. Coronary artery effects are compared with literature reports. Recommendations before sulprostone use are underlined.
-
Ann Fr Anesth Reanim · Oct 2002
Case Reports[Convulsions induced by ropivacaine after midhumeral block].
We report a case of central nervous system toxicity induced by ropivacaine following a brachial block at the humeral canal. Forty millilitres 0.75% ropivacaine (4.28 mg.kg-1) were used uneventfully, with slow injections and negative intermittent aspirations. Fifteen minutes later, the patient presented two episodes of generalised convulsions treated by diazepam, 20 mg. The total venous ropivacaine concentration measured two hours after the block was 2.3 mg.l-1.
-
Ann Fr Anesth Reanim · Oct 2002
Case Reports[Anesthesia for cesarean section in a Marfan patient with complicated aortic dissection].
We report the anaesthetic management of a 32-year-old pregnant women with aortic dissection and Marfan syndrome for caesarean section. The patient has presented at 31 weeks gestation of a first pregnancy an aortic dissection that required an emergency aortic replacement. Three years later, she presented at 31 weeks gestation with aortic dissection, mitral valve dysfunction and acute pulmonary oedema. ⋯ The initial intrathecal injection of bupivacaine, morphine and fentanyl provided rapid onset of analgesia. Epidural anaesthesia was used with diluted lidocaine and fentanyl boluses. With appropriate preoperative care and monitoring, uneventful combined spinal and epidural anaesthesia for Caesarean section was achieved in a patient with Marfan syndrome in the presence of aortic dissection complicated by mitral valve dysfunction and acute pulmonary oedema.