Cahiers d'anesthésiologie
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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.
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Outpatient anaesthesia was investigated for a two-month period by means of a questionnaire filled from the preoperative anaesthesia consultation to the surgical procedure and the discharge of the patient. 868 consultations led to schedule 260 ambulatory procedures. ENT (88 patients), paediatric surgery (73 patients) and gynaecology (63 patients) were most frequently concerned. Indications of ambulatory practice could probably be enlarged provided that recovery rooms and surgical schedules were fully adapted.
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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.
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Cahiers d'anesthésiologie · Jan 1993
Review[Is there an advantage to using opioid combinations by the peridural route?].
Epidural opioids provide a potent analgesia not devoided of side effects. In addition, epidural administration of lipid soluble opioids has no clear advantage over the IV route. Combination of epidural opioids with other analgesics may strengthen analgesia and may decrease the incidence of side effects because of a reduction in the amount of opioid administered. ⋯ Clonidine, which is a selective alpha-2-adrenergic agonist has been demonstrated to improve and to prolong analgesia produced by opioids in postoperative patients. Clonidine administration induces side effects, like sedation, bradycardia and hypotension, but allows to highly reduce the opioid dose. None of the combined techniques of analgesia implies that monitoring of the side effects of opioids has to be reduced.
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Cahiers d'anesthésiologie · Jan 1993
Review[Routes of administration of opioids excluding patient-controlled analgesia].
Opioid analgesics can be administered postoperatively by different routes. Pharmacokinetic peculiarities are evoked for the perimedullar, sublingual, oral, rectal, transcutaneous and intranasal ways.