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[Description of two techniques for brachial plexus block by the infraclavicular route]
[Article in French]
Deleuze A, Gentili ME, Bonnet F.
Departement d'anesthesie-reanimation, clinique de l'Esperance, groupe A.-Tzanck, Mougins, France. deleuze.arnaud@wanadoo.fr
PMID: 14980333 [PubMed - indexed for MEDLINE]
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[Postoperative pain in ORL surgery]
[Article in French]
Deleuze A, Gentili M.
Clinique de l'Esperance, groupe A.-Tzank, Mougins, France. deleuze.arnaud@wanadoo.fr
PMID: 14980332 [PubMed - indexed for MEDLINE]
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[Conduct in the surgical suite immediately following an anesthesia accident]
[Article in French]
Marty J; Comite d'analyse de maitrise du risque.
Service d'anesthesie-reanimation, hopital Beaujon, Clichy, France. Jean.marty@bjn.ap-hop-paris.fr
PMID: 14980331 [PubMed - indexed for MEDLINE]
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[Pyloric stenosis management in France in 1999: a postal survey]
[Article in French]
Jacqmarcq O, Orliaguet G, Carli P.
Departement d'anesthesie et de reanimation, hopital Necker-Enfants-Malades, 149, rue de Sevres, 75743 Paris cedex 15, France. olivier.jacqmarcq@nck.ap-hop-paris.fr
OBJECTIVE: The aim of this postal survey was to know how were treated infants with hypertrophic pyloric stenosis in France in 1999. METHODS: A questionnaire was sent to all French members of the Association Des Anesthesistes Reanimateurs Pediatriques d'Expression Francaise (Adarpef). RESULTS: Half the cases of pyloric stenosis treated in France in 1999 were related by the survey. Preoperative management was short lasting (24 h) while the advised guidelines regarding biologic criteria for operation were poorly followed. Nevertheless, crush induction was only performed in 80%. CONCLUSION: The management of infants with pyloric stenosis must be improved, at least to obtain the generalization of crush induction.
PMID: 14980322 [PubMed - indexed for MEDLINE]
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[Nosocomial urinary tract infection]
[Article in French]
Gauzit R, Lepape A, Moine P.
Publication Types:
PMID: 14980317 [PubMed - indexed for MEDLINE]
Drug patient information leaflets in anaesthesia: effect on anxiety and patient satisfaction.
Oldman M, Moore D, Collins S.
Department of Anaesthesia, Anaesthetic Department, Musgrove Park Hospital, Taunton, Somerset TA1 5DA, UK.
BACKGROUND: Patient information leaflets are produced for all new drugs, including anaesthetic drugs that are licensed solely for physician administration. The effect of this information on patients' satisfaction and anxiety has not been investigated previously. METHODS: Eighty-five patients were allocated randomly to receive a standard information leaflet about anaesthesia (Group 1) or the standard leaflet plus the manufacturers' patient information leaflets for propofol and remifentanil (Group 2). Anxiety was assessed using the state trait anxiety index (STAI) and a visual analogue scale (VAS) for anxiety before and after this information had been read. Patients' attitudes to this information were assessed by a short questionnaire. RESULTS: There was no significant difference in STAI or VAS scores for anxiety between the two groups before or after the information leaflets. Significantly more patients who received drug patient information leaflets felt that they had received too much information (0% Group 1 vs 18% Group 2, P=0.003). More than 64% of patients in both groups said that they would not wish to receive detailed anaesthetic drug information. There was a correlation between the STAI and the VAS scores for anxiety (R=0.8). CONCLUSIONS: A minority of patients (up to 36%) wish to receive detailed anaesthetic drug information before anaesthesia. Manufacturers' drug patient information leaflets do not alter preoperative anxiety and may be safely issued to patients requesting such information.
PMID: 15064254 [PubMed - as supplied by publisher]
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Spinal epidural abscess--a rare complication after epidural analgesia for labour and delivery.
Schroeder TH, Krueger WA, Neeser E, Hahn U, Unertl K.
Department of Anaesthesiology and Critical Care Medicine, Tubingen University Hospital, Tubingen, Germany; Department of Anaesthesiology and Critical Care Medicine, Tubingen University Hospital, Hoppe-Seyler-Strasse 3, D-72076 Tubingen, Germany.
We report a case of spinal epidural abscess formation after short-term epidural catheter placement for analgesia during labour and delivery. The patient was previously healthy and did not have any predisposing factors. Increasing back pain was the only complaint. A contrast-enhanced CT study on day 5 was inconclusive. Magnetic resonance imaging was performed and showed a large triangular-shaped abscess with adjacent inflammation of the paravertebral muscles. One day later, the patient developed a sensory deficit in the left lower limb. The neurological deficit completely resolved after surgical decompression and debridement, which was followed by antibiotic treatment.
PMID: 15064252 [PubMed - as supplied by publisher]
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Prediction of depth of sedation and anaesthesia by the NarcotrendTM EEG monitor.
Bauerle K, Greim CA, Schroth M, Geisselbrecht M, Kobler A, Roewer N.
Klinik und Poliklinik fur Anasthesiologie, Universitatsklinikum Wurzburg, Zentrum operative Medizin, Oberdurrbacher Strasse 6, D-97080 Wurzburg, Germany.
BACKGROUND: The Narcotrend(TM) (Monitor Technik, Bad Bramstedt, Germany) assesses sedation by automatic classification of EEG signals, using a scale first used for visual evaluation of the EEG. Limited information is available on its value, and only a few studies of the method exist. We set out to study the performance of the Narcotrend(TM) during propofol sedation. METHODS: In 23 ASA I-II patients, aged 18-65 yr, about to have general anaesthesia, we induced anaesthesia in steps using a target-controlled infusion of propofol. After equilibration for 8 min at each predicted propofol concentration (0.5, 1.0, 2.0, 3.0 and 4.0 micro g ml(-1)), sedation was assessed clinically with the modified Observer's Assessment of Alertness/Sedation Scale and the Narcotrend(TM) stage was noted. The prediction performance of the Narcotrend(TM) was assessed with the prediction probability PK. A PK value of 1.0 means an exact prediction on every occasion, while a PK of 0.5 is no better than a 50:50 chance of being correct. RESULTS: In 12 women and 11 men (age 42 (SD 11) yr), a total of 138 measurements were made; 129 were analysed and nine were of poor signal quality. The prediction probability for the corresponding level of sedation was PK=0.92 (SE 0.01); for the different target concentrations of propofol it was PK = 0.91 (SE 0.01). CONCLUSIONS: The Narcotrend(TM) can monitor sedation with propofol. Other sedatives, anaesthetics and opioids should be used to test this monitor.
PMID: 15064250 [PubMed - as supplied by publisher]
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Is prolongation of the QTc interval during isoflurane anaesthesia more prominent in women pretreated with anthracyclines for breast cancer?{dagger}
Owczuk R, Wujtewicz MA, Sawicka W, Wujtewicz M, Swierblewski M.
Department of Anaesthesiology and Intensive Therapy, Medical University of Gdansk, Debinki str. 7, 80-211 Gdansk, Poland.
BACKGROUND: Inhalation anaesthetics and anthracycline chemotherapeutic drugs may both prolong the QT interval of the electrocardiogram. We investigated whether isoflurane may induce or augment QTc prolongation in patients who had previously received cancer chemotherapy including anthracycline drugs. METHODS: Forty women undergoing surgery for breast cancer were included in the study. They were divided into two groups: (A) women previously treated with anthracyclines (n=20); and (B) women not treated with antineoplastic drugs (n=20). All patients received a standardized balanced anaesthetic in which isoflurane 0.5 vol% was used. The QT and corrected QT intervals were measured before anaesthesia, after induction and tracheal intubation, after 1, 5, 15, 30, 60 and 90 min of anaesthesia, and during recovery. RESULTS: In both groups we observed a tendency to QTc prolongation, but statistically significant differences among baseline values and values observed during isoflurane-containing anaesthesia were seen only in group A. During anaesthesia, significant differences in QTc values between the two groups were observed. CONCLUSION: In female patients pretreated with anthracyclines for breast cancer, the tendency to QTc prolongation during isoflurane-containing general anaesthesia was more strongly expressed than in patients without previous chemotherapy.
PMID: 15064247 [PubMed - as supplied by publisher]
Suppression of endogenous catecholamine release by anesthetics during cardiopulmonary resuscitation in the rabbit.
Kii N, Adachi N, Yorozuya T, Nagaro T, Arai T.
Ehime, Japan.
PMID: 15064280 [PubMed - in process]
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Lumbar epidural anesthesia and celiac plexus blockade for cholecystectomy in two patients with severe chronic obstructive pulmonary disease.
Sener EB, Kocamanoglu S, Ustun E, Malazgirt Z, Tur A.
Samsun, Turkey.
PMID: 15064274 [PubMed - in process]
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The radial nerve should be blocked before the ulnar nerve during a brachial plexus block at the humeral canal: [Le nerf radial doit etre anesthesie avant le nerf cubital pendant un blocage du plexus brachial au travers du canal humeral].
Guntz E, Herman P, Delbos A, Sosnowski M.
Department of Anesthesiology, Universite Libre de Bruxelles, Hopital Universitaire Saint-Pierre, Brussels, Belgium. Clinique des Cedres, Toulouse, France.
PURPOSE: The brachial plexus block through the humeral canal as described by Dupre is indicated in hand and forearm surgery. This block requires a multi-stimulation technique that emphasizes the necessity of a rigorous and safe technique. Nerve injury associated with regional anesthesia can entail significant morbidity for patients. Thus, we investigated the brachial block sequence in terms of unintended nerve stimulation as a surrogate of potential nerve injury. METHODS: Sixty patients were randomly allocated in two groups of 30. In Group I the radial nerve was blocked before the ulnar nerve. In Group II the ulnar nerve was blocked before the radial nerve. During the radial nerve approach we recorded, if present, an ulnar nerve response. During the ulnar nerve approach we recorded, if present, a radial nerve response. RESULTS: In Group I while looking for the radial nerve, in 50% of the cases, an ulnar motor response was recorded. In Group II while looking for the ulnar nerve, a radial motor response was recorded in 10% of the cases. CONCLUSION: Our results indicate that the radial nerve should be blocked before the ulnar nerve when performing a brachial plexus block at the humeral canal.
PMID: 15064264 [PubMed - in process]
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Best evidence in anesthetic practice: Prevention: alpha(2)- and ss-adrenergic antagonists reduce perioperative cardiac events.
Devereaux PJ, Leslie K.
Hamilton, Ontario. Melbourne, Australia.
PMID: 15064257 [PubMed - in process]
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The effects of candesartan and ramipril on adrenal catecholamine release in anaesthetized dogs.
Critchley L, Ding B, Fok B, Wang D, Tomlinson B, James A, Thomas GN, Critchley J.
Department of Anaesthesia and Intensive Care, Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, Hong Kong.
We have investigated the effects of the angiotensin II type 1 receptor antagonist candesartan, and the angiotensin II converting enzyme inhibitor ramipril, on catecholamine release from the anaesthetized dog's adrenal gland. These drugs were given systemically in low and high doses. The gland was stimulated electrically (0.5-12 Hz) and by angiotensin II infusion (40 ng/kg/min). Electrical stimulation resulted in frequency-dependent increases in catecholamine release. Candesartan (0.8, 4.0 mg/kg) and ramipril (0.125, 0.625 mg/kg) increased basal catecholamine release along with decreases in blood pressure. Both drugs diminished direct nerve stimulation-induced catecholamine release. When both drugs were combined, their inhibitory effect was slightly enhanced. Candesartan blocked catecholamine release induced by angiotensin II. Ramipril was not tested in this respect. The percentage of noradrenaline released during electrical stimulation of the gland remained constant and ranged from 14% to 22%. Both drugs appear to act by blocking local modulation of catecholamine release by the chromaffin cells.
PMID: 15063157 [PubMed - in process]
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CME in cardiothoracic and vascular anesthesia.
[No authors listed]
PMID: 15073724 [PubMed - as supplied by publisher]
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Narcolepsy and cardiac surgery: Can anesthesia with propofoland remifentanil be safe?
Pelaez R, Hortal FJ, Bastida E, Barrio JM, Riesgo MJ.
PMID: 15073713 [PubMed - in process]
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Anesthetic considerations during caval inflow occlusion in children with congenital heart disease.
Odegard KC, Schure A, Saiki Y, Hansen DD, Jonas RA, Laussen PC.
OBJECTIVE: Caval inflow occlusion (IO) was introduced to facilitate surgical pulmonary and aortic valvotomy without cardiopulmonary bypass (CPB). Although a technique that is used infrequently today, it remains useful in some patients with complex single-ventricle congenital cardiac defects who require an atrial septectomy. The potential for complications and anesthetic considerations have not been described previously. DESIGN: Retrospective review. SETTING: A tertiary care university teaching children's hospital. PARTICIPANTS: Eleven children, median age 3 months (range 3 days-3 years) who underwent (IO) technique for atrial septectomy. INTERVENTIONS: Atrial septectomy under IO in patients with restrictive atrial septum. Measurements and Main Results: Eleven children, median age 3 months (range 3 days-3 years), underwent IO for atrial septectomy. Mean duration of IO was 87.7 +/- 25.5 seconds. There was 1 intraoperative death (9%). After release of the caval clamps, inotropic support was necessary in 7 of 11 patients, arrhythmias occurred in 4 of 11 patients (2 atrial and 2 ventricular fibrillation), and 10 of 11 patients required blood transfusion along with boluses of calcium gluconate and sodium bicarbonate to support the circulation immediately post-IO. Duration of postoperative mechanical ventilation was 2.2 +/- 1.6 days; 10 of 11 patients (91%) survived to discharge with mean length of intensive care unit stay 3.7 +/- 2.2 days. CONCLUSION: IO is an effective technique for short intracardiac procedures without the need for CPB. Close collaboration between anesthesia and surgical staff is essential to keep the duration of IO as short as possible and because of the potential for hemodynamic instability.
PMID: 15073701 [PubMed - in process]
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