Annales françaises d'anesthèsie et de rèanimation
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Two cases of colonic gas explosion during surgery are reported. The treatment of the lesions required a partial colectomy in one case and a total colectomy in the other case. The different factors involved in such accidents are discussed. ⋯ During anaesthesia the oxygen-nitrous oxide mixture increases the intestinal concentration of these two major combustive gases. Electrocautery provides the spark triggering the explosion. The use of mannitol for colonic preparation should be questioned; the use of electrocautery to open the colon is advised against.
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A prolonged brachial plexus block with bupivacaine hydrochloride is described. Anaesthesia was induced with 40 ml of a solution made of equal parts of 0.50% bupivacaine hydrochloride and distilled water. Reversal of the motor block began 24 h later. ⋯ Whether this low osmolality caused nerve lesions was unknown. Postoperative exploration revealed a bilateral slowing down of conduction in the brachial plexus of this 73 year old patient. The importance of this finding could not be assessed.
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Ann Fr Anesth Reanim · Jan 1982
Review[Postoperative weaning from mechanical ventilation in adults].
Pulmonary complications remain the most frequent of postoperative complications (32-60), especially after upper abdominal surgery (14-41). Chronic respiratory insufficiency (80) also continues to be a major risk factor, in spite of the progress made in both anesthesiology and postoperative care. In the immediate postoperative period, weaning from mechanical ventilation is one of the most dangerous phases of anesthesia (84). We discuss the importance of weaning procedures, in particular, in patients with a high risk of pulmonary complications.
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The authors have studied 18 cases of anaphylactic shock due to suxamethonium which occurred in eastern France during the period 1972-1980. The drug responsible was succinyl iodide in 15 cases and succinyl chloride in 3. Significant contributing factors were previous drug allergy, spasmophilia and skin hypersensitivity to histamine. ⋯ If only one test was positive, this had to be confirmed on two or even three occasions. Thus, 6 patients were tested once, 9 patients were tested twice and 3 patients were tested 3 times. In case of genuine anaphylaxis, suxamethonium must definitely be avoided, and the subject should be provided with an allergy card.