Cahiers d'anesthésiologie
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This review of postoperative analgesia after knee surgery provides a practical approach to the problem. The patient can be hospitalized or undergo day surgery, with different techniques being available for each situation. For day surgery, the intra-articular administration of local anaesthetic and/or opioids, the non-steroidal anti-inflammatory drugs can be used. ⋯ It must be emphasized that a combined approach using these different techniques may be useful in order to offer better analgesia and avoid some side effects. Each technique is described with advantages, side effects and practical usage its. The choice, in each professional environment, must be the best analgesic technique which can be performed safely.
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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.
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Cahiers d'anesthésiologie · Jan 1996
[Clinical study of a mivacurium-propofol combination for laparoscopic surgery in children].
Coelioscopic surgery in children is today in constant progress and requires pharmacological agents which provide excellent surgical conditions for variable and unpredictable durations. The mivacurium-propofol association was clinically studied in this context in 30 ASA I patients aged from 6 to 16 years and appeared safe, efficient and easy to use. The orbicularis oculi and pollicis adductor stimulation allows simple and adapted neuromuscular blockade monitoring. Double-burst stimulation at the ulnar nerve improves the detection of a residual curarization.
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This study was performed to determine the incidence of sore throat 24 h after tracheal intubation in 1,268 patients ASA I or II, who had undergone elective surgery. A data form was completed. Nosing were age, sex, type of surgery, anaesthetic drug, muscle relaxant, number of intubation attempts, duration of intubation, and presence of sore throat. ⋯ There was also a greater incidence after thyroid surgery (P < 0.01). There was no correlation between sore throat and variables such as age, muscle relaxant, narcotic drug, number of intubation attempts, or duration of intubation. Lidocaine jelly and the appropriate analgesic drug reduce the incidence of sore throat following tracheal intubation.
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Cahiers d'anesthésiologie · Jan 1996
Biography Historical Article[History of anesthesia: Frederic Hewitt and nitrous oxide anesthesia].