Cahiers d'anesthésiologie
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Cahiers d'anesthésiologie · Jan 1993
Randomized Controlled Trial Comparative Study Clinical Trial[The use of antifibrinolytics in heart surgery. 3 prospective studies].
In order to assess the validity of antifibrinolytic treatments in cardiac surgery, three successive controlled randomized double-blind studies were carried out in patients undergoing a first (n = 60) or repeat surgical procedure because of a valvular or coronary disease. The first study aimed at stating the value of low doses of aprotinin compared with "classical" ones and a placebo. The second study was planned to compare tranexamic acid with low-dosed aprotinin and a placebo. ⋯ Tranexamic acid was found as effective as aprotinin on platelets function. No significant changes of seric creatinine was observed from preoperative to 4th postoperative day. A valvular non-obstructive thrombosis occurred on the second postoperative week in the tranexamic acid group.
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Cahiers d'anesthésiologie · Jan 1993
Randomized Controlled Trial Comparative Study Clinical Trial[Preventive treatment of hemodynamic disorders during conventional spinal anesthesia].
The prevention of blood pressure fall during a conventional spinal anaesthesia effected with 20 mg (4 ml) of isobaric 0.5 p. 100 bupivacaine relies on the use of vascular filling and/or a vasoconstrictor. A randomized prospective study was performed to evaluate the comparative efficacy of these two treatments. 148 patients were included and divided into three groups. Group I (n = 50): 2.5 mg IV bolus of etilefrine followed by continuous infusion (0.35 mg.kg-1.h-1). ⋯ Haemodynamic changes were fewer and less important in the etilefrine group compared with the saline infusion group. No failure and a better tolerance in the vasoconstrictor group were also to be noticed. These clinical data suggest that etilefrine could meet satisfactorily the therapeutic requirements.
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Cahiers d'anesthésiologie · Jan 1993
Randomized Controlled Trial Clinical Trial[Postoperative respiratory depression following ambulatory anesthesia for abortion. Evolution of the ventilatory response to CO2 following the use of propofol alone or in association with different opioids: comparison with midazolam in the same situation].
Sixty patients, undergoing minor gynaecologic procedures, were prospectively enrolled in this randomized study. They were anaesthetized with either propofol or midazolam supplemented or not with fentanyl or alfentanil. ⋯ No respiratory depression was observed when propofol was used alone. By contrast, midazolam alone induced a significant respiratory depression during the first postoperative hour.