Cahiers d'anesthésiologie
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Cahiers d'anesthésiologie · Jan 1996
Biography Historical Article[History of anesthesia: Frederic Hewitt and nitrous oxide anesthesia].
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Cahiers d'anesthésiologie · Jan 1996
Case Reports[Modified technique of Waters for retrograde intubation. Apropos of a case of difficult intubation].
The authors describe a case of impossible intubation by classical means in an obese 37-yr old woman, affected with encephalopathy, hydrocephalus and severe psychomotor retardation. After failure of intubation by classical methods using a flexible introducer, the patient was intubated by Waters retrograde technique using an epidural catheter passed through the thyrocricoid membrane and recovered in the mouth. Following this guide the endotracheal tube passed the glottis fairly easily with the help of a flexible "mouse tail-ended" introducer (C-Mettro, Cook, 19.0.80) inserted into the same tube to facilitate alignment of distal tube and trachea. The authors conclude that the combination of epidural catheter and flexible introducer may facilitate the retrograde technique performance; they consider this technique to be an interesting alternative when endotracheal intubation is difficult or impossible by usual methods.
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Cahiers d'anesthésiologie · Jan 1996
Comparative Study Clinical Trial Controlled Clinical Trial[Intra-articular analgesia after arthroscopy of the knee].
In 33 patients the authors compared two protocols for postoperative analgesia after elective arthroscopy of the knee. One group (n = 11) received plain bupivacaine 0.25% by intra-articular administration. ⋯ The last group (placebo group: n = 11) received the same volume of saline. The combination of bupivacaine with fentanyl reduced postoperative pain more effectively than plain bupivacaine and the analgesic effect was still present 9 hours after the arthroscopy.
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Epidural opioids for caesarean section are routinely used by many anaesthesists. Combined epidural injection of a local anaesthetic and an opioid provides a more rapid onset of profound analgesia. No side effects are observed in either the mother or the neonate with epidural "microdoses" of sufentanil or fentanyl, but the postoperative analgesia is of short duration. ⋯ Good postoperative analgesia can be obtained with intrathecal morphine or patient-controlled analgesia. Using other techniques depends on care and surveillance facilities. Opiates by spinal or intravenous route are not dangerous for breast-fed newborns.