Articles: anesthetics.
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Ann Fr Anesth Reanim · Jan 1993
Multicenter Study Clinical TrialDrugs and other agents involved in anaphylactic shock occurring during anaesthesia. A French multicenter epidemiological inquiry.
An epidemiological inquiry was carried out in departments of anaesthesia and immunology in French University and General Hospitals, as well as among those who were already known to have an allergo-anaesthesia outpatient clinic. This inquiry aimed to find out how many patients had undergone diagnostic investigations after as well as an anaphylactoid reaction during an anaesthetic in 1990 and 1991, as well as the demographic data, the kind of assessment, the accident mechanism and the drugs involved. Twenty-one French centres replied to the questionnaire and a series of 1,585 patients tested over a two-year period was thus collected. ⋯ Among these 1,585 patients, 813 were recognized as having had a reaction of immunological origin (52%). The substances involved were identified in these 813 patients as being muscle relaxants (70%), latex (12.6%), hypnotics (3.6%), benzodiazepines (2.0%), opioids (1.7%), colloids (4.7%), and antibiotics (2.6%). Suxamethonium was responsible for 43% of the IgE-dependent reactions involving a muscle relaxant, vecuronium for 37%, pancuronium for 13%, alcuronium for 7.6%, atracurium for 6.8% and gallamine for 5.6%.(ABSTRACT TRUNCATED AT 250 WORDS)
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Multicenter Study Clinical Trial Controlled Clinical Trial
An open study of ropivacaine in extradural anaesthesia.
Ropivacaine 0.5%, 0.75% and 1.0% was investigated in an open study of extradural anaesthesia in three groups of 15 patients undergoing urological or orthopaedic surgery. Following a test dose of 3 ml of 1.0% lignocaine with 1:200,000 adrenaline, ropivacaine 20 ml was given in incremental doses over 4 min via a lumbar extradural catheter. The onset time for analgesia was short in all groups: T12 was blocked 4-6 min after the end of the injection of ropivacaine. ⋯ Bradycardia occurred in seven patients and was associated with hypotension in five. Backache was experienced after operation by four patients, and three patients complained of a brief mild headache. No late adverse events were seen.
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Ann Fr Anesth Reanim · Jan 1990
Review Multicenter Study Clinical Trial[Anesthetics responsible for anaphylactic shock. A French multicenter study].
Combined allergological and anaesthetic consultations have been started in the last few years in eight French Teaching Hospitals so as to explore peranaesthetic anaphylactoid shocks. A survey was carried out in these centers in order to collect patients investigated with the same protocol, for the assessment of the incidence of anaphylaxis in France, as well as the involved drugs. Investigations were always carried out at least 6 to 8 weeks after the accident. ⋯ It would therefore seem mandatory to carry out after any anaphylactoid accident an assessment with sensitive and specific tests for anaphylaxis. Diagnosing anaphylaxis means that the involved drug should be used never again in that patient. Because muscle relaxants are by far the most involved drugs, anaesthetists should use them only when really required.