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
Comparative Study[A comparison of 3.5% dextran 40 and 4% albumin used as volume expansion solutions following heart surgery. Effects on the hemodynamic parameters and the oncotic colloidal pressure].
Dextran 40 (3.5%), a synthetic colloid solution used as a volaemic expander was compared to albumin 4% in 30 patients (15 in each group) during the first twenty hours after cardiac surgery. The patients were administered 500-600 ml.m-2 either dextran 40 or albumin at a rate of 10-12 ml.kg-1 x h-1 between 2nd and 4th postoperative hour. In the two groups, heart rate and mean arterial pressure did not change significantly but left and right filling pressures and cardiac index increased similarly. ⋯ Diuresis was not different in the two groups. No side effect was observed. Dextran 40 was efficient and could be used as a volaemic expander after cardiac surgery.