Cahiers d'anesthésiologie
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Cahiers d'anesthésiologie · Jan 1995
[Blocking of the brachial plexus: which technique(s) should be chosen?].
Brachial plexus blocks for upper extremity surgery: what are the preferred techniques? Brachial plexus anaesthesia for all types of upper extremity surgical procedures cannot be adequately achieved with a single technique. At least, two approaches are required: above the clavicle, Winnie's interscalene brachial plexus block, using a neurostimulator, has become the standard technique for shoulder surgery. Below the clavicle, midhumerus approach is the most successful approach for elbow, fore arm and hand surgery, especially for outpatient surgery. ⋯ The supraclavicular approach using surface landmarks might be the best approach due to its efficacy in achieving complete anaesthesia of the upper extremity and the rarity of secondary displacement of the catheter. Whatever the selected approach(es) to brachial plexus nerves, nerve location it best achieved by neurostimulation and often multiple neurostimulation. Insulated needles are being increasingly used due to accuracy but, currently, there is no general agreement concerning the type of needle bevel to be preferred in regard to both safety and accuracy.
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Cahiers d'anesthésiologie · Jan 1995
[Penile block. Block of ilio-inguinal and iliohypogastric nerves in children. Techniques, indications, advantages and adverse effects].
Peripheral blocks as penile blocks, ilio-inguinal ou ilio-hypogastric nerve blocks provide an useful alternative to caudal block in children, especially for penile surgery, herniotomy, and orchidopexy, frequently performed at this age. A precise anatomic location and a strict technique increase the success rate of these blocks. ⋯ Postoperative analgesia in ambulatory surgery is one of the best reasons to select these techniques. In addition they avoid prolonged motor effects observed with epidural anaesthesia.
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Cahiers d'anesthésiologie · Jan 1995
[Capnography in pediatric anesthesia: pitfalls and applications].
Expired CO2 analysis is an important area of anaesthetic monitoring. It ranges from ventilator connection to the estimation of alveolar dead space. ⋯ Confrontation between the technical specificities of CO2 monitors and the anatomical and physiological distinctive characteristics of the paediatric patient is mainly responsible for the interpretation difficulties encountered. Nevertheless capnography remains fundamental for paediatric ventilation monitoring.