Annales françaises d'anesthèsie et de rèanimation
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Although the importance of continuing medical education (CME) is a recognized fact, its modalities are still a controversial matter. In order to obtain informations on the demands and the difficulties to which French anaesthetist (AN) are faced with, the Committee for Education of the French Society of Anaesthesia (SFAR) carried out an inquiry with a questionnaire circulated to 7000 AN. ⋯ The inquiry seems to demonstrate a strong motivation for CME, as well as demands for training courses, courses extending over two days or more, and a self-assessment. The funding of the expenses as well as the difficulties to obtain a locum tenens were the two main obstacles which limited the access to CME.
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1. Propofol as an induction agent At a dose of 2 to 2.5 mg.kg-1, as a bolus injection over 30 to 60 seconds, for gynaecological procedures of short duration (abortion, D and C), propofol can be characterized as follows when compared with other induction agents: ADVANTAGES OVER METHOHEXITONE AND ETOMIDATE: decreased incidence of hiccups and abnormal movements, increased quality of induction, similar to that obtained with thiopentone, decreased postoperative nausea and vomiting. ADVANTAGES OVER THIOPENTONE: shorter recovery period, more rapid recovery of consciousness and orientation. ⋯ COMPARED WITH DESFLURANE: shorter induction time than desflurane, less respiratory problems at induction, similar recovery period, same incidence of nausea and vomiting. The administration of propofol for maintenance of anaesthesia has the main advantage of reducing the incidence of postoperative nausea and vomiting when compared to conventional halogenated anaesthetics. Respective costs of the various techniques, using propofol or the new halogenated anaesthetics, may be a criterion for choice in the future.(ABSTRACT TRUNCATED AT 250 WORDS)
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Ann Fr Anesth Reanim · Jan 1994
[Value of transcranial Doppler ultrasonography in the management of severe head injuries].
Transcranial doppler ultrasonography (TCD) is a non invasive technique for the assessment of cerebral blood flow (CBF). The aim of this prospective study was to evaluate the benefit of TCD for the monitoring of major head trauma patients. Therefore 10 of such patients, aged 17 to 37 years, had a TCD at admission and subsequently at least twice a day. ⋯ In the opposite there was no statistically significant relation between ICP and MV (r = 0.18) nor between CPP and MV (r = 0.23). However, a MV over 100 cm.s-1 was regularly associated with a ICP over 60 mmHg. The close correlation between RI, PI and ICP allows to use RI or PI to estimate ICP.(ABSTRACT TRUNCATED AT 250 WORDS)
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Propofol ensures a calm and rapid induction of anaesthesia in case of planned cardioversion for supraventricular arrhythmia. An appropriate level of anaesthesia is obtained with a dose of 1.4 to 2 mg.kg-1. Propofol does not affect the success rate of cardioversion. ⋯ The frequent association with cardiac disease, in particular valvular disease or coronary insufficiency, should be taken into account and may represent a contra-indication for the administration of propofol. Furthermore, administration of this agent is not indicated if the arrhythmia is poorly tolerated, because of the risk of increasing hypotension. The known advantages of propofol on recovery have no significant role in this indication.