Annales françaises d'anesthèsie et de rèanimation
-
Ann Fr Anesth Reanim · Nov 2007
[Out-of-hospital management characteristics of severe obese patients].
Assessment of prehospital management difficulties in morbid obese patients. Registration in several emergency departments for medical devices usable for morbid obese patients. ⋯ Management of morbid obese patients in the context of the out-of-hospital emergency medicine is frequently associated with specific and major technical difficulties. Numerous diagnostic and therapeutic devices are not currently adapted to the most severe overweight patients.
-
Ann Fr Anesth Reanim · Nov 2007
Randomized Controlled Trial[30 microg intrathecal clonidine prolongs labour analgesia, but increases the incidence of hypotension and abnormal foetal heart rate patterns].
To assess the efficacy of spinal clonidine combined with bupivacaine and sufentanil and its effects on maternal and foetal outcome. ⋯ Intrathecal clonidine 30 mug prolongs analgesia. However, it increases the incidence of hypotension, and abnormal foetal heart rate patterns. Thus, this study confirms that the use of 30 mug intrathecal clonidine for labour analgesia is not recommended.
-
Ann Fr Anesth Reanim · Nov 2007
Case Reports[Total spinal anesthesia after interscalenic plexus block].
The interscalenic block prolonged by a catheter allows an optimal analgesia for important surgery of the shoulder. Its realization is easy but exposes to potentially serious complications. We report a case of spinal anaesthesia due to the accidental catheterization of the medullar canal at the time of an interscalenic block. ⋯ This observation recalls that in spite of all the safety measures, the realization of locoregional anaesthesia can be burdened with accidents. The proscription of a major sedation and the use of short needles are elementary rules to realize the interscalenic block. The improvement of puncture techniques, ultra-sound location or use of stimulative catheters can decrease the risk of this kind of accident.
-
Ann Fr Anesth Reanim · Nov 2007
[Endovascular treatment of vasospasm following subarachnoid aneurysmal haemorrhage].
An endovascular treatment of vasospasm following a subarachnoid aneurysmal haemorrhage is to be implemented if the patient presents clinical or biological symptoms arguing for brain ischemia in conjunction with increased Doppler velocities despite well controlled systemic haemodynamic. Treatment might be either pharmacological or haemodynamic. Calcium and phosphodiesterase inhibitors can be administered. ⋯ Balloon angioplasty has a long lasting effect but can be applied only to proximal spasm. Complications of its use are rare but life threatening. In some cases, both the pharmacological approach and the mechanical approach are used in combination.
-
Ann Fr Anesth Reanim · Nov 2007
Case Reports[Use of coupled plasma filtration adsorption for septic shock treatment].
Coupled plasma filtration adsorption (CPFA) is a new technology proposed for septic shock, removing both pro- and anti-inflammatory mediators. We report the first use of CPFA in France. The patient was 80-years-old and was admitted to the intensive care unit because of septic shock from urinary source. ⋯ At the end of the sessions, a noteworthy hemodynamic and inflammatory improvement was observed. This case confirms the feasibility and the relative simplicity of CPFA. It also illustrates the recent and few scientific data of the medical literature concerning this technology.