Anesthésie, analgésie, réanimation
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Anesth Analg (Paris) · Jan 1981
[Curing trial of complicated oncologic pain by D-phenylalanine (author's transl)].
Aim of investigations: Very often, chronic pain treatments used for the management of terminal ill cancer patients do not prevent acute or incident pain from coming up. For twenty months D-phenylalanine (DPA), an enkephalinase inhibitor, has been investigated in order to forestall this pain. ⋯ DPA seems a useful drug to prevent acute or incident pain in malignant diseases. Our data point out the consequences the enkephalinases inhibitors will take up for the cure of intractable cancer pain.
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Anesth Analg (Paris) · Jan 1981
[Intervention among patients with right bundle branch block and left anterior hemiblock. Operatory risk (author's transl)].
In order to assess the risk of advanced heart block during anesthesia in patients with right bundle branch block and left anterior hemiblock, 35 consecutive patients were monitored throughout the pre-, intra- and postoperative period. As conventional ECG monitoring may only detect advanced atrioventricular block, patients were monitored according to the Holter method which can easily detect even minor changes of atrioventricular conduction namely slight increased PR interval or dropped P wave. All patients were asymptomatic, in normal sinus rhythm without second degree AV block. ⋯ They immediately regressed at the termination of the sinus bradycardia either spontaneously or following atropine injection, strongly suggesting the responsability of increased vagal tone. Thus general or epidural anesthesia did not compromise infranodal conduction in any of the observed patients. These data indicate that anesthesia can be safely used without prophylactic preoperative insertion of pacemakers in patients with asymptomatic chronic right bundle branch block and left anterior hemi-block.
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Anesth Analg (Paris) · Jan 1981
[Percutaneous cordotomy. Actual situation in pain surgery (author's transl)].
A personal experience with 138 percutaneous cordotomies is presented. The results and complications are compared to those of 49 open cordotomies at C1-C2 level. ⋯ For this reason the author prefers in certain cases open cordotomy in a modified microsurgical technique which is described. It is outlined that in the authors opinion cordotomy should be restricted to cancer pain.
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Anesth Analg (Paris) · Jan 1981
[Complications of loco-regional anaesthesia in obstetrical practice (author's transl)].
Complications of loco-regional anaesthesia in obstetrics are usually due to several factors: 1. choice of drugs: this must be judicious, taking into account duration of effect, potency and eventual maternal and foetal toxicity. This rule includes also morphinic drugs; 2. choice of technique: taking into consideration the stage of labour and also the eventual surgical procedure. Paracervical block must be avoided because of the numerous side-effects, chiefly foetal distress. ⋯ Peridural anaesthesia may present some complications, like extensive peridural anaesthesia, hypotension. In eclampsia and gemellarity, loco-regional, anaesthesia must be induced with the utmost caution. Moreover, an unrecognized uterine rupture may happen during labour under medullary anaesthesia if the patient had previously a caesarian section.