Cahiers d'anesthésiologie
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Cahiers d'anesthésiologie · Jan 1993
Review[Recovery from propofol and its antiemetic effect in pediatric anesthesia].
The incidence of postoperative nausea and vomiting in children is significantly decreased or shows a tendency to decrease when propofol is given compared to any other anesthetic drugs or techniques. In this review, the role of factors associated with postoperative nausea and vomiting in the context of propofol anesthesia are discussed.
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Anaesthesia for ambulatory surgery implies a strict selection of patients. Screening tests are non specific, compared to these ordered for in-patients. ⋯ The detection of an asymptomatic anomaly by routine testing is extremely infrequent and does not lead to changes in the operating schedule or in the outcome of anaesthesia. Clinical examination and patient history are the only predictive elements, so systematic complementary tests should be abandoned and replaced by judicious selective prescription.
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Cahiers d'anesthésiologie · Jan 1993
Review[The use of patient-controlled analgesia by the obstetrical patient].
Patient-controlled analgesia is a technique of analgesia recently developed for obstetrical pain. During labor, PCA using intravenous administration has already been used for more than a decade but meperidine may be conceivable replaced by fentanyl with which maternal and neonatal side-effect seem reduced. ⋯ After cesarean section, PCA using intravenous morphine has been shown to produce less pain relief than epidural morphine but is associated with a high degree of satisfaction. The wider use of PCA in obstetrics is however limited by its cost and will thus require evaluation of its cost/effectiveness ratio.
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Cahiers d'anesthésiologie · Jan 1993
Comparative Study[A comparison of 3.5% dextran 40 and 4% albumin used as volume expansion solutions following heart surgery. Effects on the hemodynamic parameters and the oncotic colloidal pressure].
Dextran 40 (3.5%), a synthetic colloid solution used as a volaemic expander was compared to albumin 4% in 30 patients (15 in each group) during the first twenty hours after cardiac surgery. The patients were administered 500-600 ml.m-2 either dextran 40 or albumin at a rate of 10-12 ml.kg-1 x h-1 between 2nd and 4th postoperative hour. In the two groups, heart rate and mean arterial pressure did not change significantly but left and right filling pressures and cardiac index increased similarly. ⋯ Diuresis was not different in the two groups. No side effect was observed. Dextran 40 was efficient and could be used as a volaemic expander after cardiac surgery.
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Outpatient anaesthesia was investigated for a two-month period by means of a questionnaire filled from the preoperative anaesthesia consultation to the surgical procedure and the discharge of the patient. 868 consultations led to schedule 260 ambulatory procedures. ENT (88 patients), paediatric surgery (73 patients) and gynaecology (63 patients) were most frequently concerned. Indications of ambulatory practice could probably be enlarged provided that recovery rooms and surgical schedules were fully adapted.