Annales françaises d'anesthèsie et de rèanimation
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Three types of hyperalgesia can occur during the postoperative period: primary hyperalgesia, which disappears with wound healing, secondary or central hyperalgesia, which can lead to chronic pain, and opiate-induced hyperalgesia. Different drugs, most of which are NMDA receptors antagonists, are used to decrease or prevent the risk of central or opiate-induced hyperalgesia. However, it is difficult to determine whether they are really effective and at which dosage: the results of most published studies are difficult to interpret because of methodological problems. The two most frequent of those are: absence of objective measurement of secondary hyperalgesia and difficulties targeting an at risk population.
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Ann Fr Anesth Reanim · Jan 2012
[Tolerance and efficacy of peripheral nerve blocks for carpal tunnel release].
Several peripheral nerve block techniques (PNB) are performed for hand surgery. Their tolerance by patients or their efficacy are poorly described. We evaluated them for blocks at the wrist and at the brachial canal. ⋯ Wrist blocks are less tolerated than brachial canal blocks. The musculocutaneous nerve might often participate in the palm sensitive innervation. For open carpal tunnel release, median, ulnar and musculocutaneous nerves blocks at the brachial canal should be preferred.
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Ann Fr Anesth Reanim · Jan 2012
Case Reports[Trap in severe trauma: the rotary atlantoaxial dislocation].
We reported the case of asymptomatic traumatic atlantoaxial dislocation in a 14-year-old woman. Clinical diagnosis of this uncommon dislocation is difficult and often made late. The early diagnosis by CT scan is necessary to avoid secondary aggravation. Integrity of the transverse ligament of the atlas is a determining factor for atlantoaxial stability and allows orthopaedic treatment after reduction using moderate traction on the head.
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Ann Fr Anesth Reanim · Jan 2012
Case Reports[Dissection of the descending aorta complicated by preeclampsia at 30 weeks of gestation: medical treatment and caesarean delivery].
The authors report the case of a dissection of the descending thoracic aorta in a woman in the third trimester of the pregnancy. After an initial medical therapy by a combination of three intravenous anti-hypertensive medications, a caesarean section was decided under general anaesthesia at 30 weeks of gestation as the result of the occurrence of a severe preeclampsia. The aetiology, diagnosis, and anaesthetic management are discussed.