Annales françaises d'anesthèsie et de rèanimation
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Ann Fr Anesth Reanim · Jan 1982
Comparative Study[Nitrous oxide and pressures exerted on the trachea by endotracheal tubes. Study on a tracheal model].
The authors studied the effects of nitrous oxide diffusion, using a tracheal model, on the pressure of several endotracheal tube cuffs. Studies carried out showed an increase in volume and pressure of the cuffs related to time exposure and nitrous oxide concentrations used. Use of a self-controlled pressure cuff or filling the cuff with inspired gas composition should be of value to counteract or to prevent the diffusion effect.
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Ann Fr Anesth Reanim · Jan 1982
Case Reports Comparative Study[Intraventricular morphine analgesia. Apropos of 4 cases, 1 with self-administration].
Intractable pain in four patients enduring disseminated cancer was treated by intraventricular morphine. For all these patients, previous efficiency of opiates therapy had been assessed by a positive trial of epidural injections of morphine. The latter method had to be stopped and a switch to intraventricular morphine was motivated in three cases by a local non-tolerance to the subarachnoid catheter. ⋯ Trial times were respectively of eight days, one month, two months and seven months, with a self administration system in one case. In comparison with the epidural and lumbar intrathecal administration of morphine, the authors insist upon the quality of analgesia obtained, the absence of respiratory depression, the comfort and minimal daily quantities of morphine injected (inferior to one mg daily in three cases). Enlightened by these four cases, the authors also discuss of relative importance of the spinal and brain mechanisms involved in morphine analgesia.
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Caudal analgesia may be used with general anaesthesia in painful surgery. Caudal anaesthesias were performed by the authors, as the single anesthetic technic for digestive or orthopedic surgery in nine children. The technic is sure, efficient and without any complications. Caudal anaesthesia seems to be interesting in the child with respiratory pathology or with morphologic facial abnormalities.
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Ann Fr Anesth Reanim · Jan 1982
[Use of a ternary mixture of local anaesthetics for peridural anaesthesia during urgent caesarean operation. Report on 125 cases].
125 caesarean operations are conducted under peridural anaesthesia with a mixture of local anaesthetics containing per milliliter: 2.5 mg of bupivacaine, 2.5 mg of etidocaine, 12.5 mg of lidocaine, and 5.10(-6) epinephrine. The dose injected is 23.37 +/- 1.98 ml, the volume necessary for blocking a metamer being 1.18 +/- 0.10 ml/segment. ⋯ Apgar is 8.98 +/- 1.62 after one minute and 9.68 +/- 1.31 after five minutes. These results prove that under perfect circumstances it is possible to get out the baby in about ten minutes.
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A technique of continuous axillary brachial plexus block, using an epidural Tuohy needle and an epidural catheter, is described. Studies were carried out in ten patients using this technique with bupivacaine as a local anesthetic drug. ⋯ Good analgesia was obtained in nine out of the ten patients. Thus this technique allows pain-free postoperative period in hand surgery.