Annales françaises d'anesthèsie et de rèanimation
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Ann Fr Anesth Reanim · Jul 2011
Review[Benefits and safety of perioperative pregabalin: a systematic review].
Perioperative gabapentine administration improves analgesia, reduces postoperative nausea and vomiting, but increases sedation. Pregabalin is also a gabapentinoid, with an improved bioavailability. This systematic review evaluates the analgesic effect and tolerance of perioperative pregabaline. ⋯ A favorable benefit risk-ratio is demonstrated only for major surgery (excluding ambulatory surgery). The lack of data concerning tolerance of pregabalin in the elderly and/or in case of renal dysfunction forbids any conclusion in these populations.
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Present the clinical signs of bradykinin-mediated angioedema, a disease little known to intensive care anaesthesiologists, and develop their scientific basis with recent data on management in emergency and perioperative care. ⋯ Bradykinin-mediated angioedema should be evoked in the case of recurrent and transitory oedema. Emergency management has evolved thanks to the commercialization of new molecules. Prevention of attacks during surgery and for during childbirth is important. The availability of C1 inhibitor concentrate in sufficient doses should be verified prior to the procedure. A multi-site reference centre (CREAK) has been created to help clinicians manage this disease. Patients with this disease should be identified in emergency departments. Health establishments, which cannot all have emergency stocks, should set up procedures for rapid provision or the transfer of patients to reference sites.
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The purpose of this review is to draw up a statement on current knowledge available on perioperative management of Parkinson's disease patients. ⋯ In France, approximately 150,000 persons suffer from Parkinson's disease, a neurodegenerative disorder of central nervous system. Parkinson's disease results in selective and irreversible loss of dopaminergic neurons in the substantia nigra pars compacta. Medications based on dopaminergic drugs are used to control motor symptoms and improve motor function. Development of surgical approach, especially deep brain stimulation, has revolutionized the medical management of many patients with Parkinson's disease. Anesthesia of these patients remains a challenge for the clinician. The aim of this review is to describe anaesthetic considerations of patients with Parkinson's disease and to discuss management of antiparkinsonians medications during the perioperative period.