Biomedical subjects

E Vandermeersch

Publications and source records attributed to E Vandermeersch.

58 records · Page 4Linked to original sources

PubMed1983

Cardioprotective effects of lidoflazine in extensive aorta-coronary bypass grafting.

The cardioprotective effects of lidoflazine, a calcium entry blocker, were tested in patients undergoing multiple aorta-coronary bypass grafting (at least four grafts). Intermittent aortic cross-clamping at 25 degrees to 28 degrees C was used. Mean cross-clamp time was 11 minutes for one distal anastomosis. Patients were randomized into three groups: a control group (I), a group (II) pretreated with 0.5 mg . kg-1 lidoflazine intravenously before cardiopulmonary bypass (CPB), and a group (III) pretreated with 1 mg . kg-1 lidoflazine intravenously. The following markers of ischemia are used: (1) adenosine triphosphate (ATP), creatine phosphate (CP) and glycogen determined in transmural left ventricular biopsy specimens taken at the beginning and end of CPB; (2) ultrastructure in a similar pair of specimens; and (3) hemodynamic recovery 15 minutes after cessation of CPB. At the end of the intervention, ATP decreased to 73% in Group I but remained unchanged in Groups II (98%) and III (88%). CP decreased to 82% in Group I and remained unaltered in Groups II (100%) and III (110%). Glycogen decreased in Group I (to 44%) and in Group II (78%) but remained unchanged in Group II (138%). Ultrastructural study showed better preservation of the glycocalyx and sarcolemma in Group III than in Group I. Left ventricular stroke work index remained unaltered after CPB in Group III but decreased in Groups I and II to about 60% of its initial value. Thus lidoflazine pretreatment protects the myocardium in a dose-dependent manner against deterioration of myocardial function and structure.

Adenosine Triphosphate↗

PubMed1979

Total I.V. anesthesia using a continuous etomidate infusion.

Total I.V. anesthesia was given to 20 patients using an Etomidate continuous infusion to maintain sleep, combined to Fentanyl analgesia, Droperidol, Pancuronium for muscular relaxation and artificial ventilation with an oxygen-air mixture. All these patients were carefully observed during and for several hours after the anesthesia and the results noted. With the Fentanyl dosages used in this technique, peroperative analgesia was frequently insufficient. More Fentanyl would probably be needed with the inherent dangers of prolonged postoperative depression.

Adult↗

PubMedDate not supplied

Interaction of antibiotics on pipecuronium-induced neuromuscular blockade.

STUDY OBJECTIVE: To measure the interaction of two antibiotics (clindamycin and colistin) on neuromuscular blockade induced by pipecuronium bromide (a new long-acting, steroidal, nondepolarizing neuromuscular blocking drug). DESIGN: Prospective, randomized, placebo-controlled study. SETTING: Inpatient gynecologic and gastroenterologic service at a university medical center. PATIENTS: Three groups of 20 ASA physical status I and II patients with normal kidney and liver function, taking no medication, and undergoing elective surgery under general anesthesia. INTERVENTIONS: Anesthesia was induced with propofol and alfentanil intravenously (IV) and maintained with a propofol infusion and 60% nitrous oxide in oxygen. Pipecuronium bromide 50 micrograms/kg was administered after reaching a stable baseline of single-twitch response. At 25% recovery of pipecuronium-induced neuromuscular blockade, patients received one of two antibiotics, clindamycin 300 mg or colistin 1 million IU, or a placebo. MEASUREMENTS AND MAIN RESULTS: The recovery index (RI, defined as time from 25% to 75% recovery of neuromuscular blockade) was measured using the single-twitch response of the adductor pollicis muscle with supramaximal stimulation of the ulnar nerve at the wrist. RI after administration of an antibiotic (given at 25% recovery) was measured and compared with RI of the control group using Student's unpaired t-test. Statistical analyses of the results showed a significant prolongation of the recovery time (from 25% to 75% recovery) of 40 minutes for colistin. CONCLUSIONS: When this type of antibiotic is used during anesthesia with pipercuronium as a muscle relaxant, one must be aware of a significant prolongation of an already long-acting neuromuscular blockade and (although not observed in this study) possible problems in antagonism.

Adolescent↗

PubMedDate not supplied

Fetal heart rate abnormalities after regional analgesia for labor pain: the effect of intrathecal opioids.

BACKGROUND AND OBJECTIVES: Intrathecal opioids used to relieve labor pain have been associated with uterine hyperactivity and nonreassuring fetal heart rate abnormalities. We retrospectively evaluated all charts of singleton, term, vertex-presenting parturients in active labor requesting neuraxial pain relief during a 1-year period for the occurrence of nonreassuring fetal heart rate tracings. METHODS: Three different strategies to relieve labor pain were routinely used in our department: conventional epidural using 10 mL bupivacaine 0.125% and sufentanil 0.75 microg/mL; combined spinal and epidural (CSE) using intrathecal sufentanil (7.5 microg); and CSE using intrathecal bupivacaine (2.5 mg) and sufentanil (1.5 microg). Charts (n = 1,293) were evaluated for nonreassuring fetal heart tracings and uterine hyperactivity as well as for neonatal and labor outcome. RESULTS: Intrathecal sufentanil (7.5 microg) produced significantly more nonreassuring tracings and uterine hyperactivity. However, this did not result in more cesarean deliveries or detrimental neonatal outcome. CONCLUSION: Based on this retrospective analysis, we conclude that intrathecal sufentanil in a dose of 7.5 microg has the potential to result in more nonreassuring fetal heart rate tracings compared with both intrathecal analgesia using a bupivacaine (2.5 mg)/sufentanil (1.5 microg) mixture and epidural analgesia using bupivacaine, sufentanil, and epinephrine. Reg Anesth Pain Med 2001;26:257-262.

Adult↗