Annales françaises d'anesthèsie et de rèanimation
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Ann Fr Anesth Reanim · Jan 1992
Case Reports[Difficult intubation managed by laryngeal mask and fibroscopy].
A case is reported of a patient due to undergo a combined kidney and pancreas transplant who proved to be difficult to intubate. This diabetic hypertensive 35-year-old male patient also had ankylosing spondylitis. Mouth opening was normal (more than fingers' breadth), the chin-sternum distance was 4 cm on full cervical flexion, and cervical extension was only slightly impaired. ⋯ A paediatric fibroscope, passed through the LM tube, served as guide for the endotracheal tube. The mask was not removed, although its cushion was slightly deflated, so as not to extubate the patient. The benefits and usefulness of a laryngeal mask in predictable and unpredictable cases of difficult intubation are discussed.
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Eleven anaesthesia ventilators were instrumentally tested under various conditions. They included: Excel and Modulus II Plus (Ohmeda); 710 and Servo anaesthesia circle 985 (Siemens); Jollytronic (Soxil) and Elsa (Engström); SA2 and Cicero (Dräger); ABT 4,300 (Kontron); Monnal A and the prototype Alys (Taema). The test circuit comprised a two compartment model lung, a pneumotachograph, a pressure gauge in the "airway". ⋯ Increasing fresh gas flow raised the minute volume delivered in six ventilators. It is concluded that, during extreme ventilatory conditions, the inspired volume must be adjusted so as to maintain the inspired tidal volume. However, ventilators which increase inspiratory time in response to an increased mechanical load cannot be adjusted by this way.
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Ann Fr Anesth Reanim · Jan 1992
Comparative Study[Desflurane (I 653) and sevoflurane: halogenated anesthetics of the future?].
Sevoflurane is an halogenated methyl isopropyl ether. It is potent, non explosive and non flammable. It reacts with soda lime to form traces of a related ether which has not been shown to have any toxic effect on animals chronically exposed to it in a closed system. ⋯ Its MAC has been estimated to be about 7.2 vol % in man. Desflurane did not lead to any liver, lung or kidney injury in laboratory rats, even during hypoxia and enzyme induction. Desflurane undergoes little biotransformation, although the presence of volatile metabolites or covalent tissue-bound products cannot be excluded.(ABSTRACT TRUNCATED AT 250 WORDS)
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Ann Fr Anesth Reanim · Jan 1992
[Monochromatic infrared halogenated gas analyzer and handling errors].
Monochromatic infrared gas spectrometers cannot identify volatile agents. Such an analyser (Capnomac, Datex) was tested while performing two errors: a) erroneous selection of the agent on the analyser, the vaporizer being filled with the correct agent; b) total or partial filling of the vaporizer (Vapor 19, Dräger) with an incorrect agent, the analyser being set for the agent the vaporizer was specified for. Three agents were studied, halothane (H), enflurane (E) and isoflurane (I). ⋯ In case of erroneous filling of the vaporizer, the concentration displayed was always different from that expected. When E or I was delivered with an H vaporizer, the analyser being set on H, the concentration displayed was 3 to 9 times higher than the concentration that had been set. On the other hand, when H was delivered with an E or I vaporizer, the analyser being set to E or I, the concentration displayed was 4 to 8 times lower.(ABSTRACT TRUNCATED AT 250 WORDS)