Search PubMed⌕ Search

Biomedical subjects

C Saint-Maurice

Publications and source records attributed to C Saint-Maurice.

At least 91 records · Page 5Linked to original sources
PubMed1985

[Continuous peridural anesthesia in children less than 2 years old].

Continuous epidural anaesthesia was carried out in 23 children (age 13.9 +/- 6 months, weight 9.09 +/- 2.5 kg) scheduled for long surgical procedure (soft tissue release for club-foot, "pull-through" for Hirschsprung disease, various genito-urinary procedures). The lumbar epidural space was punctured under general anaesthesia with a 19 G Tuohy needle. A graduated 24 G polyurethane catheter was then inserted and fixed. The local anaesthetic used was bupivacaine 0.25% (0.71 +/- 0.02 ml X kg-1), with or without 1:200,000 adrenaline. Five and 10 min after injection of bupivacaine, heart rate was significantly decreased (p less than 0.05) when compared with pre-induction values, but systolic blood pressure did not change. No other haemodynamic changes occurred. Analgesia was sufficient in all but two cases at incision. Mean duration of surgical procedure was 143 +/- 9.2 min. The time of the first reinjection was significantly longer if bupivacaine with adrenaline was used (116 +/- 2.34 min), when compared with bupivacaine without adrenaline (68.9 +/- 3.92 min) (p less than 0.001). No systemic analgesic was needed during the surgical procedure and anaesthesia was maintained either with halothane (inspiratory fraction less than 0.5%) or enflurane (inspiratory fraction less than 0.8%). All children were extubated at the end of the surgical procedure. The catheter was maintained in 16 children for postoperative analgesia. The first postoperative injection was given 7.1 +/- 0.45 h later. The catheter remained in situ 26.7 +/- 4.1 h. No complication was observed. Thus, during surgery, the need for systemic analgesia was avoided and a rapid and safe postoperative recovery was obtained.(ABSTRACT TRUNCATED AT 250 WORDS)

Anesthesia, Epidural↗
PubMed1985

Ventilatory responses to carbon dioxide in children during nitrous oxide-halothane anaesthesia.

The ventilatory response to carbon dioxide was studied in 12 unpremedicated children, aged 20-68 months, weighing between 10 and 20 kg, under nitrous oxide-halothane anaesthesia. Tidal volume (VT) and end-tidal carbon dioxide tension (PE'CO2) were continuously measured by pneumotachograph and capnograph. Minute ventilation (VE), respiratory rate (f), mean inspiratory flow (Vl) and effective inspiratory cycle (Tl/Ttot) were calculated during anaesthesia at three different inspired halothane concentrations (0.5, 1 and 1.5%). The ventilatory response to carbon dioxide was determined by relating the increase in ventilation during exposure to 2% carbon dioxide to the change in end-tidal carbon dioxide concentration. When the inspired concentration of halothane increased, there were significant decreases in VE, VT, Vl, and a significant increase in PE' CO2. The slope of the carbon dioxide response under light nitrous oxide-halothane anaesthesia (0.5% halothane) was relatively flat (18.64 ml min-1 kg-1 mm Hg-1) when compared with the mean values published for anaesthetized adults, children or neonates. When the inspired concentration of halothane was increased, the slope decreased significantly (39% of initial value at 1% inspired halothane, 26% at 1.5%). The addition of carbon dioxide produced significant increases in VE, VT and Vl but no change in respiratory rate. No statistical difference was observed in the slope of carbon dioxide response between the initial and "control" periods which were measured at the same inspired halothane concentration (0.5%).

Anesthesia, Inhalation↗
PubMed1985

Changes in ventilatory patterns during halothane anaesthesia in children.

Changes in ventilatory variables (VE, VE, f, Tl/Ttot, VT/Tl, PE'CO2) were studied in 12 unpremedicated children, weighing between 10 and 20 kg, during halothane anaesthesia. At an inspired concentration of 0.5% halothane, respiratory rate increased, VT decreased, and VE did not change markedly. When the inspired halothane concentration increased further, there was a significant decrease in VE, mainly as a result of a marked decrease in VT. PE'CO2 increased significantly and inspiratory duty cycle decreased at high inspired halothane concentrations. On return to baseline (0.5% halothane), there was a significant decrease in inspiratory timing and a significant increase in PE'CO2. The relations between these changes and the effect of halothane on inspiratory muscles are discussed.

Anesthesia, Inhalation↗
PubMed1985

[Caudal anesthesia in children: two-year retrospective study].

Caudal anesthesia has been used on a daily basis for two years in the Department of Anesthesia of Saint-Vincent-de-Paul Hospital. A retrospective study on 231 children was done to specify the procedures, the indication and the dosage of local anesthetics.

Anesthesia, Caudal↗
PubMed1984

[Premedication using intrarectal midazolam. Study of effective dosage in pediatric anesthesia].

The object of this study was to determine the optimal dose of midazolam given per rectum which would produce sedation adequate for inducing inhalational anaesthesia in paediatric practice. Five doses were studied: 0.15, 0.25, 0.30, 0.35 and 0.40 mg X kg-1. The criteria used to appreciate the effectiveness of the sedation at 30 min were the change in the child's behaviour, with a scale of 6 levels, and the acceptance of the mask and anaesthetic vapours. There was a significant correlation between the dose administered and the degree of sedation, as well as between the dose administered and the lack of reaction to the mask. Significantly better results were found with the higher doses of 0.35 and 0.40 mg X kg-1, when compared with the children who had received 0.15 and 0.25 mg X kg-1. Only in the groups who received 0.35 and 0.40 mg X kg-1 were the degrees of sedation and acceptance of induction considered as adequate. The dose of 0.35 mg X kg-1 seemed to be the best dose for adequately premedicating a child.

Age Factors↗
PubMed1984

Pharmacokinetics of lignocaine in children following caudal anaesthesia.

The time course of the plasma lignocaine concentration, following caudal anaesthesia, was studied in 11 healthy children (3.5-9 yr). Plasma lignocaine concentrations were measured for up to 6 h after administration (5 mg kg-1). Peak plasma concentration was 2.05 +/- 0.08 micrograms ml-1 and occurred at 28.2 +/- 2.9 min after administration. Pharmacokinetic parameters determined from a two-compartmental model were similar to those observed after the i.v. or extradural administration of lignocaine in adults, except for a longer half-life of elimination (155 +/- 32 min). Since the total body clearance of lignocaine was similar in children (15.4 +/- 1.2 ml min-1 kg-1) to that in adults, the longer half-life of elimination was attributed to a larger volume of distribution in the children (3.05 +/- 0.40 litre kg-1).

Anesthesia, Caudal↗