Annales françaises d'anesthèsie et de rèanimation
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Ann Fr Anesth Reanim · Jun 2013
Comparative Study[Opioid-sparing effect of ketamine during tonsillectomy in children].
In the adult population, Ketamine is currently used as an antihyperalgesic and opioid-sparing agent during the perioperative period. However, for doses of ketamine up to 0.5mg/kg, these effects have not been found in pediatric population. The aim of the present study was to evaluate the efficacy of a preoperative bolus of 1mg/kg of ketamine on postoperative pain intensity and morphine consumption in children undergoing tonsillectomy. ⋯ These results suggest that 1mg/kg of ketamine administered right after anaesthesia induction in children undergoing tonsillectomy did not result in an opioid sparing effect.
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Ann Fr Anesth Reanim · Jun 2013
[Assessment of practices in postoperative analgesia in caesarean before and after implementation of an information program].
To assess the improvement of practices in postoperative analgesia after a cesarean section post implementation of a corrective program. ⋯ After an awareness campaign of the paramedical and medical staff, we succeeded in improving significantly the routine use of analgesics regardless of their level. Nevertheless healthcare professionals still seem reluctant to administer opioids.
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Complications at extubation remain an important risk factor in anaesthesia. Airway related complications at extubation are relatively frequent but are usually dealt with by simple basic measures. We report a new case of respiratory complications associated with tracheal extubation in a 59-year-old woman. ⋯ Both tests showed a large thyroid "goitre plongeant" (plunging goiter) and compressive. In the suites, a thyroidectomy was performed with excision of a large cervical plunging goiter para- and retropharyngeal bilateral chest, allowing extubation successfully. The postoperative course was uneventful.
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Ann Fr Anesth Reanim · Jun 2013
Case Reports[Labour epidural analgesia for a parturient with a factor XI deficiency: an ill-considered challenge or a reasonable risk?].
The authors report the performance of a labour epidural analgesia in a 26-year-old parturient presenting a moderate factor XI (FXI) deficiency. If haemostasis disorders usually contraindicate an epidural analgesia (with a risk of epidural haematoma), a moderate FXI deficiency is not an absolute contraindication to perform such an epidural analgesia. Desmopressin, sometimes used in surgery to reduce the bleeding, was administered to withdraw the catheter in better haemostasis conditions. No neurological signs were observed.