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Biomedical subjects

B Roquefeuil

Publications and source records attributed to B Roquefeuil.

At least 55 records · Page 3Linked to original sources
PubMed1983

[Value of intraventricular morphine analgesia in intractable neoplasm pain. Apropos of 8 cases with self-administration in 4].

Intractable pain in 4 patients having disseminated cancer was treated by intraventricular morphine. For all these patients, previous efficiency of opiates therapy was assessed by a positive trial of epidural injections of morphine. The latter method had to be stopped and a switch to intraventricular morphine was motivated, in 3 cases, by a local non-tolérance to the subarachnoid catheter. In one case, an intraventricular system was inserted at the first onset. In all cases, the intraventricular system consisted of a "Holter" type device, using a reservoir implanted subcutaneously in the frontal scalp and connected at right-angle with a catheter inserted in the lateral ventricle. Trial times were respectively of 8 days, one month, two months and six months (this latter case still under trial). In comparison with the epidural and lumbar intrathecal administration of morphine, the authors insisted upon the quality of analgesia obtained, the absence of respiratory depression, the comfort and minimal daily quantities of morphine injected (inferior to one mg daily in three cases). Enlightened by these 4 cases, the authors also discussed the relative importance of the spinal and brain mechanisms involved in morphinic analgesia.

Adult↗
PubMed1982

[Intraventricular morphine analgesia. Apropos of 4 cases, 1 with self-administration].

Intractable pain in four patients enduring disseminated cancer was treated by intraventricular morphine. For all these patients, previous efficiency of opiates therapy had been assessed by a positive trial of epidural injections of morphine. The latter method had to be stopped and a switch to intraventricular morphine was motivated in three cases by a local non-tolerance to the subarachnoid catheter. In one case, an intraventricular system was inserted at the first onset. In all cases, the intraventricular system consisted of a Holter type device, using a reservoir subcutaneously implanted in the frontal scalp and connected at right-angle with a catheter inserted in the lateral ventricle. Trial times were respectively of eight days, one month, two months and seven months, with a self administration system in one case. In comparison with the epidural and lumbar intrathecal administration of morphine, the authors insist upon the quality of analgesia obtained, the absence of respiratory depression, the comfort and minimal daily quantities of morphine injected (inferior to one mg daily in three cases). Enlightened by these four cases, the authors also discuss of relative importance of the spinal and brain mechanisms involved in morphine analgesia.

Aged↗
PubMed1981

[Blood gas levels using spontaneous breathing and the Bain circuit. Our experience during head surgery (author's transl)].

The authors use the Bain Circuit with spontaneous breathing during head surgery (neurosurgery and ophthalmological procedures). Suitable for both adult and pediatric use, it seems to be, due to its unique characteristics, the choice circuit for all anaesthesia procedures in which the physician does not have direct control over the patient's head. Comparative analysis of blood gas levels is effected, on the one hand in children connected to a Digby-Leigh system and Bain Circuit, and on the other hand in adults, some of whom are connected to a two-way system and the other under a filter circuit; all of the patients are then connected to the Bain Circuit. In children the analysis of results shows that for an identical protocol of anaesthesia the quality of spontaneous breathing obtained using the Bain Circuit is the same as that obtained using the Digby-Leigh. In adults anaesthetized using fluothane and with spontaneous breathing, the average level of hypercapnia under filter circuit and Bain Circuit is identical. Also, the same level of alveolar hypoventilation is obtained under spontaneous breathing with the two-way and Bain Circuit systems when there are properly provisioned. Thus this work confirms other studies by showing that the Bain Circuit is particularly well adapted to head surgery because of its low weight and easy manageability. On the other hand, when using spontaneous breathing the level of alveolar hypoventilation, and thus the degree of hypercapnia, is directly related to the level of anaesthesia and independent of the circuit chosen. Only the setting up of controlled breathing would allow the physician to work under the desired level of normo or hypocapnia.

Adolescent↗
PubMed1981

[Nurseling and children general anaesthesia in brain neuroradiology: from gaz tomoencephalography to brain computer tomography (author's transl)].

The authors give their experiences in nurseling and children brain neuroradiology anaesthesia. Sodium gammahydroxybutyrate has been definitively adopted after multiples anaesthesial protocoles for the gaz tomoencephalographic exam, known for its technical risks. The gamma OH gives a perfect cardiac and pulmonary stability in difficult conditions, with normal intracranial pression, even in children anaesthesia with Halothane (0.5%) for complementary analgesic effect or with fractionate injections of dextromoramide. Pneumoencephalography has been releguated in second place by the even of brain computer tomography except some particular indications. But this exam qualified as painless is usually indicated in fragile and deficient childrens. Though the intravenous iodated contrasted substance injection can improve the scan image quality and may induce secondary effects at 2 cm3/kg dose. It's again gamma OH after correct premedication that gives stable, perfect immobility, cardiac and pulmonary stability in an ideal anaesthesia for non ventilated patients. The only critical aspect of this method consists on a prolonged and imprevisible delay to awake so that it cannot be an ambulatory anaesthesial method. Therefore it appears that gamma OH in spite of brain computer tomographic event, is an interesting anaesthesic drug but non definitive in brain neuroradiological exam for childrens.

Adolescent↗