Annales françaises d'anesthèsie et de rèanimation
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Despite the availability of modern neuromuscular blocking agents with short or intermediate duration of action, incidence of residual neuromuscular blockade remains very high. Evidences have been recently provided that residual curarization must be defined as a train-of-four ratio below 0.9 at the thumb adductor during the recovery period after anaesthesia. Residual curarization may be associated with serious adverse events related to respiratory depression, pharyngeal dysfunction, hypoxemia and prolongation of the length of stay in the recovery room. Appropriate choice of drugs, perioperative monitoring of neuromuscular function and large indications of pharmacological reversal may reduce the incidence of residual curarization and improve the patient's safety in the postoperative setting.
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Ann Fr Anesth Reanim · Oct 2005
Case Reports[Postobstructif pulmonary oedema after endotracheal extubation at the recovery of general anaesthesia].
We report two cases of postobstructif pulmonary oedema occurring after extubation at the recovery of general anaesthesia and presenting some similarities. The young age of the patient and the occurrence of upper airway obstruction after extubation, as well as the radiologic nondependent distribution of alveolar pattern are typical. The underlying pathophysiology seems to be the mechanical disruption of the alveolar-capillary membrane.
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Ann Fr Anesth Reanim · Oct 2005
[Clinical evaluation of the single use Laryngeal Tube in adults: the LTD].
The Laryngeal Tube (LT) is a supra-laryngeal device indicated to manage upper airway during anaesthesia. Leak pressures were lately reported higher for the LT as compared to the LMA. A recent study found a small amount of proteinaceous material on LMA after classical sterilization suggesting a risk of contamination by unconventional transmissible agents (prions). The aim of this study was to evaluate the effectiveness of the single use Laryngeal Tube: the LTD. ⋯ the use of the LTD was easy and successful. Moreover the LTD totally excluded the risk of contamination by unconventional transmissible agents.
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Ann Fr Anesth Reanim · Oct 2005
Case Reports[Refractory oedema: think about systemic capillary leak syndrome].
Systemic Capillary Leak Syndrome (SCLS) is a rare and recently discovered disease. The diagnosis must be evoked in front of an hypovolaemic shock associated with a refractory anasarca. ⋯ SCLS is diagnosed when a patient meet a compatible clinical situation with an hypoalbuminemia in spite of relative hemoconcentration. Evidence of a monoclonal gammapathy constitute an additional clue.
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Ann Fr Anesth Reanim · Oct 2005
Case Reports[Late thrombosis of a drug-eluting coronary stent after antiplatelet therapy discontinuation].
We reported the late thrombosis of a drug-eluting coronary stent related to discontinuation of antiplatelet therapy for venous surgery of the right leg more than half and a year after its implantation. After this acute myocardial infarction, a cardiac assistance device has to be used as a bridge to transplantation because of end stage ischaemic cardiopathy. Antiplatelet therapy management must be revisited for eluting stents, which can clot lately after its implantation.