Cahiers d'anesthésiologie
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Anaesthesia for fetal distress is usually indicated for emergency caesarean section. General anaesthesia, which is the classical technique in these cases, remains the leading cause of anaesthesia-related maternal mortality. Difficult intubation and Mendelson's syndrome are mostly responsible for these fatalities. ⋯ For example, a "prophylactic" epidural instituted soon after the beginning of labor may be lifesaving in a patient with obvious signs of difficult intubation. A clear definition of safe standards of equipment and practices both to prevent Mendelson's syndrome or to cope with a failed intubation through a "failed intubation drill" is of paramount importance. Finally, a comprehensive communication between anesthetic and obstetrical teams is one of the most useful ways to allow a safer approach of the management of obstetric emergencies such as caesarean section for fetal distress.
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Cahiers d'anesthésiologie · Jan 1994
Comparative Study[Comparative study of propofol versus thiopental-halothane in the occurrence of oculocardiac reflex and postoperative vomiting after surgery for strabismus in children].
Strabismus surgery in children is associated with side-effects, intraoperative oculocardiac reflexes in relation with muscular tractions and postoperative vomiting. Studies with propofol anaesthesia in this surgery have shown a lower incidence of these side-effects. So, a prospective study compared these incidences with propofol (P) versus thiopental/halothane (T+H) anaesthesia. Propofol appears to be efficient in reducing postoperative vomiting but might be associated with more frequent OCR.
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Cahiers d'anesthésiologie · Jan 1994
[Laryngeal masks in pediatric anesthesia. Apropos of 251 cases].
A series of 251 anaesthesias with a laryngeal mask (LM) in a paediatric surgery unit is studied retrospectively. After some short training, using LM is most often easy and allows a good airway control without any frequent or severe complications. Therefore this technique should quickly supplant the facial mask and many endotracheal intubations.
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Pain is a major factor of respiratory decompensation after chest trauma. General and/or regional analgesia improve alveolar ventilation, make physiotherapy easier and often avoid mechanical ventilation. Concerning regional techniques, epidural, intercostal and interpleural routes have their respective indications and contraindications, benefits and risks. When suitable, epidural analgesia appears to be the preferable technique.