Cahiers d'anesthésiologie
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Cahiers d'anesthésiologie · Jan 1995
Randomized Controlled Trial Clinical Trial[Effects of preoxygenation methods on the course of PaO2 and PaCO2 in anesthetic post-induction apnea].
This study compares two preoxygenation techniques by blood gases measurements during induction of anaesthesia. After hospital ethics committee approval, 17 adult surgical patients, ASA I, all free of cardiac or lung disease were randomly assigned to two groups. Before preoxygenation, venous and radial artery canulations were performed. ⋯ The group I had significantly higher PaO2 immediately after preoxygenation (397 +/- 49 vs 293 +/- 86 mmHg) and the time for SaO2 to decrease to 95% was significantly shorter in group II (3 +/- 1 vs 1.87 +/- 0.99 min). PaCO2 was not different after preoxygenation in group II. In summary, healthy and young patients receive better protection against hypoxia with normal breathing of 100% for 4 minutes.
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Cahiers d'anesthésiologie · Jan 1994
Randomized Controlled Trial Clinical Trial[Effects of ondansetron and metoclopramide on postoperative nausea and vomiting after epidural anesthesia in children].
We studied the preventive effect on postoperative nausea and vomiting (PONV) of ondansetron, metoclopramide and placebo associated with epidural anaesthesia. Sixty children, ASA I or II, 4 to 12 yr old underwent surgery for inguinal hernia repair (n = 30) or orchidopexy (n = 30). Children were randomly assigned to a postinduction intravenous medication group, ondansetron (5 mg.m-2), metoclopramide (0,12 mg.kg-1) or a saline solution placebo. ⋯ The incidence of postoperative emesis in the metoclopramide group was 25%, whereas that of placebo group was 10%. The administration of ondansetron was associated with a lower (P = 0.017) incidence of postoperative vomiting if compared to the metoclopramide group. In conclusion ondansetron given preoperatively had proven to be an effective treatment for PONV after epidural block for lower abdominal surgery.
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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.