Annales françaises d'anesthèsie et de rèanimation
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Ann Fr Anesth Reanim · Oct 2012
Review Meta Analysis[Early rehabilitation for neurologic patients].
Rehabilitation improves the functional prognosis of patients after a neurologic lesion, and tendency is to begin rehabilitation as soon as possible. This review focuses on the interest and the feasibility of very early rehabilitation, initiated from critical care units. ⋯ Rehabilitation will be directed to preventing decubitus complications and active rehabilitation. The sooner rehabilitation is started; the better functional prognosis seems to be.
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Ann Fr Anesth Reanim · Oct 2012
Randomized Controlled Trial Comparative Study[Storage at room temperature does not change cisatracurium onset time: a prospective, randomized, double-blind controlled study].
Storage of cisatracurium at room temperature seems to have no effect on its degradation in vitro contrary to the recommendations of storage at +4°C. The purpose of this study was to evaluate the influence of cisatracurium' s storage temperature on its onset time. ⋯ This study demonstrated that cisatracurium's storage at room temperature had no influence on its onset time. It provides an argument for the preservation of cisatracurium at room temperature for a period not exceeding 21 days. Monitoring the onset of curarization may increase the quality score of intubation.
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Ann Fr Anesth Reanim · Oct 2012
Randomized Controlled TrialEffects of a single 1200-mg preoperative dose of gabapentin on anxiety and memory.
Gabapentin has antihyperalgesic and potential anxiolytic effects. We therefore evaluated the effects of gabapentin premedication on anxiety, amnesia, and sedation. We tested the primary hypothesis that 1200mg of oral gabapentin 2 to 3h before surgery reduces preoperative anxiety. Our secondary hypothesis was that gabapentin administration is sedative without causing preoperative amnesia. ⋯ Gabapentin premedication, 1200mg, provided preoperative anxiolysis without causing sedation or impairing preoperative memory.
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Ann Fr Anesth Reanim · Oct 2012
Review[Controversies in neuroanaesthesia: positioning in neurosurgery].
Positioning of the neurosurgical patient has several features such as the existence of specific positions (i.e: sitting, prone hyperlordotic, crouching ou kneeling positions) or the range of facilities for the same surgical indications. The last point, a source of controversy, is the subject of this review. Current indications for the sitting position, positioning for lumbar spine surgery and prevention of eye injuries are successively addressed.
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Ann Fr Anesth Reanim · Oct 2012
Review[Inhaled agents in neuroanaesthesia for intracranial surgery: pro or con].
Isoflurane, desflurane and sevoflurane all preserve cerebrovascular carbone dioxide (CO(2)) reactivity. They are all concentration-dependant cerebral vasodilatators and decrease cerebral metabolism. Sevoflurane induces the smallest cerebral vasodilatation and preserve cerebral autoregulation up to 1.5CAM, compared to isoflurane and desflurane which impair it upon 1CAM. ⋯ Finally, neuroprotective properties have been described in experimental model for all the inhaled agents but clinical proofs are still lacking. In conclusion, for intracranial surgery without any ICHT inhaled agents can be used as a maintenance anesthetic with a preference for sevoflurane. In case of ICHT or a risk of ICHT during the surgery, propofol is preferred for it slightest effect on ICP and cerebral hemodynamic.