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Biomedical subjects

J P Racle

Publications and source records attributed to J P Racle.

35 records · Page 2Linked to original sources
PubMed1986

[Comparative study of general and spinal anesthesia in elderly women in hip surgery].

The choice between regional versus general anaesthesia for elderly patients undergoing hip surgery is debated. It is vitally important to see if the type of anaesthetic administered affects per- and postoperative morbidity and mortality. Seventy women more than 75 yr old suitable for spinal anaesthesia were included in this study. They were randomly divided into two groups: in one (n = 35), general anaesthesia was given with sodium thiopentone, fentanyl, enflurane and vecuronium; in the other (n = 35), spinal anaesthesia was performed with 3 ml 0.5% bupivacaine in isobaric solution. During the anaesthetic period, there were no statistically significant differences between both groups in systolic arterial pressure falls or in increases in the heart rate X systolic arterial pressure product. No serious cardiovascular collapse was encountered. Seven patients (20%) receiving general anaesthesia had mental changes against four only (14.2%) in the spinal group. In patients having general anaesthesia, 22.9% developed bronchopneumonia as opposed to 8.6% in the spinal anaesthesia group (p less than 0.05). The mortality rate at three months was rather similar in the two groups. It was concluded that, in order to reduce the incidence of postoperative central dysfunction and bronchopneumonia, spinal anaesthesia should be preferred in geriatric patients for lower limb surgery.

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PubMed1984

[Acute voluntary carpipramine poisoning with ventricular tachycardia].

A case of carpipramine overdose is reported. The patient was admitted with ventricular tachycardia 4 h after taking 2.40 g of the drug. This disappeared at the sixth hour. In overdoses with other tricyclics, ventricular tachycardia was successfully treated within 30 min of starting a sodium lactate perfusion. In the case presented, reversal of the ventricular tachycardia coincided with the half-life of the drug; the effects of perfusing 1000 ml sodium lactate over 2 h seemed doubtful. This sodium resistance may be related to a relative hypokalemia (3.4 mmol X 1(-1) ). The use of sodium lactate for the treatment of overdoses with drugs with short-half lives appeared questionable.

Acute Disease↗
PubMed1980

[Cardio-vascular therapeutics study criteria of viability of a patient with cerebral death (author's transl)].

The authors revied cardio-vascular physiologics criteria in order to valid a patient with cerebral death for a non mutilant therapeutic study conform to ethical standards as set out in the Declaration of Helsinki. Various tests are discussed. it is necessary to ensure homeostasis and to know if adrenergic receptors are active. The principal problem is the vascular effects of cerebral death on local circulations. It is concluded that it is difficult to use a patient with irreversible coma as a biological model.

Animals↗
PubMed1976

[Clinical and anatomopathologic effect of Bisolvon in respiratory resuscitation].

N cyclohexyl-N-methyl-2 amino -3.5 dibromobenzyl, amine hydrochloride or Bisolvon is an alkaloid derived from vasicine whose fluidizing effects on bronchial secretions are well-known. This study which consisted in a randomization involved 40 patients that were being submitted to a respiratory reanimation, half of whom received Bisolvon intravenously. The patients were improved by the treatment with Bisolvon as can be seen from the following: - fewer bronchial aspirations; - less fluid secretions; - a decrease in alveolar cells; - an increase in bronchial cells; - a reduced increase in total mucus. These results evidence an original action ascribable to Bisolvon on the bronchial cell.

Bromhexine↗
PubMedDate not supplied

Failure of phenylephrine to prolong isobaric bupivacaine spinal anesthesia in elderly patients.

BACKGROUND AND OBJECTIVES: The effects of phenylephrine on the duration of spinal anesthesia produced by plain bupivacaine were investigated in a double-blind study of 100 elderly patients. METHODS: Each patient received a basic solution of 3 ml 0.5% plain bupivacaine to which was added either 1 ml physiologic saline, 0.2 ml (1 mg) 0.5% phenylephrine plus 0.8 ml normal saline, 0.4 ml phenylephrine plus 0.6 ml normal saline, 0.6 ml phenylephrine plus 0.4 ml normal saline, or 0.8 ml phenylephrine plus 0.2 ml normal saline. RESULTS: The duration of sensory block (measured by two- and four-segment regression times and times to regression to T12 and L2 dermatomes) was not statistically prolonged by addition of phenylephrine. CONCLUSION: It is concluded that, in an attempt to prolong plain bupivacaine spinal anesthesia, the addition of phenylephrine does not appear to be advantageous for routine clinical practice.

Aged↗
PubMedDate not supplied

A comparison of cardiovascular responses of normotensive and hypertensive elderly patients following bupivacaine spinal anesthesia.

The hypotensive effects of spinal anesthesia were investigated in 60 patients aged 75 years or older and divided into two groups: 30 normotensive patients (group 1) and 30 treated hypertensive patients (group 2). In both groups, spinal anesthesia was performed in lateral decubitus position with 3 ml 0.5% isobaric bupivacaine. Hemodynamic measurements were performed before the establishment of spinal blockade and repeated during the 60 minutes following intrathecal injection. Median cephalad level (T10) and ranges of sensory blockade were similar in the two groups. Changes from baseline to lowest blood pressures showed significant decreases in group 2 compared with group 1:10.7% in SPB, 11.2% in MBP, and 14.8% in DBP. Hypotension was observed in three group 1 patients and ten group 2 patients. Five patients in group 2 (but none in group 1) had a SBP decrease of 40% from baseline or more. The decreases in MBP and DBP were persistent after 60 minutes. These results suggest that pre-existing hypertension can be recognized as an important factor to explain blood pressures changes during isobaric bupivacaine spinal anesthesia in elderly patients.

Aged↗
PubMedDate not supplied

[Sedation with flunitrazepam during spinal anesthesia].

The clinical effects of flunitrazepam (FNZ) as IV sedative agent for spinal anaesthesia was studied. Of 112 elderly patients undergoing hip surgery, 40.2% have required a total dose of 26.6 +/- 2.3 mcg X kg-1. The repeat doses were 9.3 to 13.3 mcg X kg-1. A good state of sedation was obtained in 81% of patients, with a linear relationship between narcosis states and FNZ's doses. In 93% of cases, FNZ was provided peroperative amnesia without post-operative somnolence. No clinically adverse cardiovascular effects were encountered. There was a small, but statistically significant increase in arterial carbon dioxide tension. In summary, FNZ provided useful sedation.

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