Annales françaises d'anesthèsie et de rèanimation
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Ann Fr Anesth Reanim · May 2007
Clinical Trial[Psoas compartment block with general anaesthesia: descriptive study of 93 cases].
During many years the approach to the lumbar plexus has been the anterior paravascular technique described as a "3-1" block by Winnie. The posterior approach results in a complete block of the principal nerves of the lumbar plexus. The goal of the study was to evaluate the performance of the psoas compartment block with general anaesthesia. ⋯ The psoas compartment block with general anaesthesia have shown it feasibility and efficiency on intra- and postoperative analgesia during hip surgery.
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Ann Fr Anesth Reanim · May 2007
Case Reports[Is it necessary to revalue the risk of a gas embolism complicating an intervention with carbon dioxide insufflation?].
Due to the characteristics of the carbon dioxide, gas embolism occurring during coelioscopy using this gas is usually considered as non critical. We report three observations of gas embolism which have occurred during laparoscopic surgery, one mild and two having led to death in spite of hyperbaric oxygen therapy. These observations prompted us to reevaluate the role of carbon dioxide in the severity of gas embolism.
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Ann Fr Anesth Reanim · May 2007
Case Reports[Spontaneous spinal epidural haematoma during pregnancy].
Spontaneous spinal epidural haematomas are quite rare. We report here the case of a 27-year-old woman, without previous history of relevant medical disorder, who presented with acute paraplegia at 36 weeks of gestation. MRI performed in emergency revealed a T8 epidural haematoma. ⋯ Spontaneous spinal epidural haematomas require a prompt diagnosis because neurologic prognosis essentially depends on the interval of time between onset of symptoms and surgical decompression. Obstetrical management especially depends on the term of pregnancy. For the anaesthesiologist, the difficulty is the management of both pregnant condition (full stomach general anaesthesia) and spinal cord compression (maintenance of spinal cord perfusion pression and limitation of ischaemia and oedema).
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Ann Fr Anesth Reanim · Apr 2007
Review[Critical analysis of noninflammatory treatments of sepsis: lessons learned from previous trials].
A large number of immunomodulatory therapies has been evaluated in patients with severe sepsis and septic shock. Until recently, none of these treatments has ever demonstrated any benefit in terms of decreased mortality. Many biases could interfere with the results of these clinical trials linked to poor comprehension of immune response, pharmacological errors, selection bias, and mistakes in the evaluation of the patients and in the interpretation of the results. Based on these methodological flaws, the authors try to define directions for future clinical trials.