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J du Cailar

Publications and source records attributed to J du Cailar.

At least 37 records · Page 2Linked to original sources
PubMed1988

[The course of blood concentrations of propofol administered at a constant rate, combined with fentanyl].

The blood concentration of propofol was studied in 14 ASA 1 informed patients, who were to undergo orthopaedic or plastic surgery lasting at least 90 min. Anaesthesia was induced with a 2 mg.kg-1 bolus of propofol together with 0.86 microgram.kg-1 fentanyl. This was followed by a constant rate infusion of propofol and fentanyl, 5 mg.kg-1.h-1 and 3 micrograms.kg-1.h-1 respectively. The mean duration of propofol infusion was 153 +/- 63 min, with extremes of 90 and 315 min. Propofol concentration was measured using gas phase chromatography on total arterial blood; the lower limit of detection was 0.05 mg.l-1. During the infusion, blood concentrations were found between 2 and 4 mg.l-1. It was 2.25 mg.l-1 at the fifth min; this was 80% of the concentration found at the 120th min. There was in fact no statistically significant difference between the values found at the 90th, 120th and 150th min. On stopping the infusion, the concentrations fell rapidly during the first 5 min, and then more slowly. By the 30th min, it had reached a value 4.5 times less than that at the end of the infusion. However, individual variations were found, which could explain delayed recovery. The calculated pharmacokinetic parameters were: elimination half-life = 41.7 +/- 20 min, clearance = 2.14 +/- 0.55 l.min-1 and equilibrium distribution volume = 43.4 +/- 15.2 l. These results are discussed. It is therefore possible to give propofol continuously at a constant rate without having any accumulative effect.

Adolescent↗
PubMed1988

[Comparison of propofol and propanidid administered at a constant rate].

So as to compare the anaesthesia obtained using propofol with that obtained using propanidid, 40 ASA I patients, aged between 18 and 50 years, who were to undergo elective orthopaedic or plastic surgery lasting more than 60 min, were randomly divided into two equal groups, one receiving propofol (PF) and the other propanidid (PD). All the patients received 0.5 mg atropine, 100 mg pethidine and 7.5 mg droperidol (10 mg if weight greater than 60 kg) intramuscularly 45 min before induction. Patients in group PF were then given 2 mg.kg-1 propofol over 1 min and 0.9 microgram.kg-1 fentanyl over 3 min, followed by a constant rate infusion of 5 mg.kg-1.h-1 propofol and 3 micrograms.kg-1.h-1 fentanyl. For PD patients, the doses of fentanyl were identical; they were given 10.6 mg.kg-1 propanidid over 3 min for induction, and 37 mg.kg-1.h-1 for maintenance. All the patients were intubated and ventilated mechanically. The usual anaesthetic parameters were monitored at induction, during surgery, and during recovery. Consciousness was lost more quickly with propofol (p less than 0.05), but the corneal reflex returned more rapidly in group PD (p less than 0.02). The time required for a full return to normal consciousness was identical in both groups. The fall, during induction, and the increase, during recovery, of Pasys were greater in group PD (p less than 0.05 and less than 0.001 respectively). Padia and heart rate were lower in group PF after the 30th min (p less than 0.05 and less than 0.01 respectively).(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1988

[Cervical peridural selective sensitive anesthesia in surgery and rehabilitation of the hand].

Active patient participation in the operative and postoperative programme is very important for tenolysis, tendon grafts and joint releases. Different anesthesic means can be used to perform selective sensitive analgesia. Cervical epidural anesthesia was used for fifteen cases of hand surgery. The technique is described, the results are analyzed. Indications and use of cervical epidural anesthesia for hand surgery are discussed.

Adult↗
PubMed1987

[Comparison of propofol and methohexital for dental and maxillofacial surgery].

A prospective study has been undertaken to compare a new intravenous anaesthetic agent, propofol, to methohexitone in 40 ASA I or II patients aged between 18 and 50 years undergoing maxillo-facial surgery and divided into two groups. Intramuscular premedication was standardized for all patients. In group I, propofol 2 mg X kg-1 was injected over 1 min in a peripheral venous line with fentanyl 0.86 microgram X kg-1, followed by an infusion of propofol 5 mg X kg-1 X h-1 and fentanyl 3 micrograms X kg-1 X h-1. In group II, the fentanyl dosage was the same as in group I, whilst methohexitone 3 mg X kg-1 was given for induction and 4.5 mg X kg-1 X h-1 for maintenance of anaesthesia. The following were recorded during induction, maintenance and recovery; haemodynamic parameters using a non invasive method; respiratory parameters; quality of anaesthesia; side-effects. Statistical analysis was performed using the Student t test and qualitative analysis using the Schwartz comparison test at 2%. The following results were found: the quality of anaesthesia with propofol was superior to that of methohexitone during the three stages of anaesthesia. The duration of induction was similar in both groups, but the quality of induction (occurrence of more minor side-effects; p less than 0.05) and intubation was in favour of propofol (p less than 0.05). During maintenance, stability of anaesthesia and a lesser incidence of side-effects were again in favour of the propofol group, in which a slower rate was also found (p less than 0.001).(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1987

[Midazolam used for premedication reinforces sleep induced by flunitrazepam].

This single blind study aimed to discover possible effects of intramuscular premedication with midazolam on the sleep induced by intravenous flunitrazepam. 24 male patients, aged 17 to 71 years, who were to undergo surgery to the distal parts of an upper limb under regional anaesthesia, were randomly assigned to two equal groups: in the midazolam group, an intramuscular premedication of 0.12 mg.kg-1 midazolam with 0.5 mg atropine was given, whereas in the control group atropine only was used. In all patients, 1 mg flunitrazepam was given intravenously 45 min after the premedication, before carrying out regional anaesthesia. No other drug was given. In the midazolam group, the time of loss of spontaneous conversation was reduced (p less than 0.05), as well as the time of eye closure (p less than 0.001), and the time for recovery of the capacity to count backwards was increased (p less than 0.001). So, premedication with 0.12 mg.kg-1 midazolam intravenously 45 min before giving 1 mg flunitrazepam reinforced the sleep induced by the latter.

Adult↗
PubMed1986

[Effect of positive end expiratory pressure on arterial oxygenation during bronchoalveolar lavage for proteinosis].

To maintain good cellular oxygenation during bronchopulmonary lavage for alveolar proteinosis is often a difficult problem to solve. A case is reported of alveolar proteinosis in whom four lavages were performed. Details of the technique are discussed, as are the problems with expedients used to improve PaO2. The use of a 10 cmH2O positive end-expiratory pressure was useful only during the "in-phase"; in the "out-phase", it worsened the PaO2. PaO2 during lavage in patients with alveolar proteinosis can only be improved by three ways: cancellation of the shunt during lung filling and, during the "out-phase", an increase in FIO2 or pulmonary artery occlusion by a balloon.

Adult↗
PubMed1986

[Value of hemodilution in maxillofacial surgery for postoperative traumatic edema and graft viability].

The effects were studied of normovolaemic haemodilution on postoperative traumatic oedema after surgical repair of craniofacial disjunction (CFD) and on pedicle graft viability after excision of squamous carcinomas of the floor of the mouth (CFM). Fourty patients were studied: twenty operated on for CFD and twenty for CFM. These patients were randomly assigned to the treated or the control groups. The treated ones were operated on under moderate normovolaemic haemodilution induced with a colloid solution (Plasmion). The subsequent haematocrits were 0.29 +/- 0.01 for the CFD group and 0.30 +/- 0.02 for the CFM group. The biometric parameters and the length of the surgical procedures were comparable for the two series. Operative blood loss was less in the treated series (p less than 0.001 for the CFD group and p less than 0.01 for the CFM group), thus needing less blood transfusion (p less than 0.001). The postoperative oedema in the treated CFD series was less (p less than 0.001), although the oncotic pressure and the plasma osmolality were decreased in this series (p less than 0.05). On the other hand, viscosity in the hemodiluted series was significantly decreased in comparison with the control series (p less than 0.001). Graft viability was significantly improved in the treated series (p less than 0.05). Thus, normovolaemic haemodilution was a very useful adjunct in plastic and reconstructive surgery of the face and the mouth. This technique had three advantages: reduction of postoperative traumatic oedema after CFM repair, graft viability improvement after mouth carcinoma excision and blood saving in both procedures.

Carcinoma↗
PubMed1985

[Effect of exclusive enteral feeding with Enteronutril on serum lipids].

Ten patients aged between 18 and 73 years admitted to our intensive care unit were placed on exclusive artificial nutrition with Enteronutril receiving on average 2.855 +/- 496 kcal/day (715 +/- 125 g). This solution is poor in lipids (1.5%) and contains no linoleic acid (C18:2). Its effects on serum lipids were analysed after 5, 10 and 15 days of treatment. Total cholesterol (TC) and phospholipids (PL) showed no significant change. However, triglycerides (TG) rose on d15 and pre-beta-lipoproteins were significantly higher on d5. The latter rose further from d10 to d15. The C18:2 fraction of total lipids (TL) fell precipitously on d5 (-50%). Although C18:2 remained stable from d5 to d10, a new, slower decrease occurred from d10 to d15. This decrease was accompanied by a specific rise in oleic (C18:1) and palmitoleic (C16:1) acids. Palmitic (C16:0) and stearic (C18:0) acids were unaffected. Arachidonic acid (C20:4) remained within normal limits up to d15. Eicosatrienoic acid which was measurable on d0 presented no significant rise during the course of the study. The changes in C18:2 were inversely proportional to those of C18:1 or C16:1. This translated a lack of C18:2 relative to delta 9 desaturase (freed of the inhibition usually exerted by C18:2). These results showed that the body could maintain a sufficient level of linoleic acid to synthesize arachidonic acid by drawing on its C18:2 reserves from fatty tissue. Nevertheless, these reserves were progressively exhausted beyond d10, thereby causing a shortage of arachidonic acid.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1985

[Course of the neuromuscular block under atracurium. Comparison with alcuronium].

Using a standardized anaesthetic protocol, the continuous monitoring of the twitch height after a 0.1 Hz stimulus was used to follow the evolution of curarization following injection of either atracurium (0.6 mg . kg-1) or alcuronium (0.2 mg . kg-1). The maximum twitch height inhibition was always greater than 99% of the control value and occurred after 107 +/- 50 s with atracurium (n = 30) and 172 +/- 120 s for alcuronium (n = 30) (p less than 0.02). Although surgical stage of muscular relaxation (twitch height less than 25% of reference value) was the same for both drugs (55 +/- 15 min for alcuronium versus 52 +/- 10 min for atracurium; n = 30 for both groups), the clinical duration (spontaneous restoration of twitch height to 90% of the reference value) was significantly longer (p less than 0.005) for alcuronium: 89 +/- 20 min (n = 10) versus 62 +/- 9 min for atracurium (n = 10). The spontaneous return to normal of the train of four was also significantly longer (p less than 0.001) for alcuronium: 118 +/- 23 min (n = 10) versus 69 +/- 7 min for atracurium (n = 10). The recovery index (the time required for twitch height to rise from 25% to 75%) was three times quicker (p less than 0.01) for atracurium (10 +/- 3 min; n = 10) than for alcuronium (30 +/- 13 min; n = 10).(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1985

Bromocriptine inhibition of hyperprolactinemia during surgery.

The material included two groups of 10 women undergoing diagnostic laparoscopy. General anesthesia was administered by injection of 0.1 mg fentanyl followed by infusion of propanidide-succinylcholine. The control group received no medication prior to surgery, whereas patients in the experimental group were given 5 mg bromocriptine per os. Blood samples for prolactin determinations were drawn as the patients were placed on the operating table and immediately following surgery. The association of anesthesia and surgery caused prolactin levels to rise from 10.9 +/- 3.5 to 168 +/- 18.7 ng . ml-1 in the control group (p much less than 0.001) and from 3.5 +/- 0.5 to 7.5 +/- 1.1 ng . ml-1 in the test group (p less than 0.001). A significant difference was noted between the two groups for their pre- and postoperative levels and prolactin response (p less than 0.05, p much less than 0.001 and p much less than 0.001, respectively). The proposed protocol successfully suppresses prolactin increase during surgery and constitutes a useful tool for investigating hyperprolactinemia and its consequences during this same time. Possible applications include in vitro fertilization and studies on prolactin receptor-bearing tumors.

Anesthesia, Intravenous↗
PubMed1984

[Midazolam].

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Benzodiazepines↗
PubMed1984

[Comparison of midazolam and flunitrazepam as premedication administered rectally in infants].

The present study aimed to assess the pharmaco-clinical profile of infants premedicated with rectal midazolam. The results were compared with those of a reference drug, flunitrazepam. Infants undergoing minor surgery were divided into three groups: group A (n = 30), with a mean age of 15.8 +/- 13.2 months and a mean weight of 8.6 +/- 3.3 kg, receiving 0.33 mg X kg-1 flunitrazepam; group B (n = 15), with a mean age of 11.2 +/- 10.7 months and a mean weight of 9.3 +/- 3.1 kg, receiving 0.3 mg X kg-1 midazolam; and group C (n = 30), with a mean age of 15.5 +/- 9.1 months and a mean weight of 10.7 +/- 2.5 kg, receiving 0.4 mg X kg-1 midazolam. An aqueous solution of each drug was administered with atropine sulfate (0.02 mg X kg-1) 20 min prior to induction of anaesthesia. The drug was well tolerated in 84% of cases. Statistically significant haemodynamic changes consisted of: a 9 c X min-1 decrease in heart rate (p less than 0.05) and a 12 mmHg decrease in systolic and diastolic blood pressures (p less than 0.05) in group C; a 6 mmHg decrease in systolic blood pressure (p less than 0.05) in group B. The tranquilizer action was either excellent or good in 93% of groups B and C compared with only 40% in group A (p less than 0.001 in both cases). Somnolence was attained in 60% of group A, 26.6% of group B and 30% of group C. A mask was much better accepted in group C (86.6%) than in group B (66.6%; p less than 0.05) or in group A (36.6%; p less than 0.01). Therefore, midazolam given rectally at 0.4 mg X kg-1 was better than flunitrazepam, because of a greater therapeutic effect for an equivalent rate of side effects.

Age Factors↗
PubMed1984

[Midazolam combined with neuroleptanesthesia as a hypnotic].

Two groups of 20 women randomly distributed underwent general anaesthesia based on dextromoramide and droperidol. Midazolam was given 0.2 mg X kg-1 in the first group, 0.4 mg X kg-1 in the second. Induction was considered satisfactory in more than 90 p. cent of patients in both groups (NS). Midazolam produced a decrease of systolic blood pressure of 9 mm Hg in group I (p less than 0,001) and 11 mm Hg in group II (p less than 0,001) as well as a decrease in diastolic blood pressure of 5 mm Hg (p less than 0,025) and 7 mm Hg (p less than 0,005) respectively. Heart rate decreased significantly only in group II (by 4 c X mn-1, p less than 0,01). These alterations were similar in both groups and did not reach physiologic importance. Maintenance of anesthesia as well as recovery were uneventful in all cases. Higher doses of midazolam reduced only slightly the dose of the neuroleptic. Its is concluded that midazolam is a good induction agent neuroleptic-analgesic anaesthesia. The use of more than 0.2 mg X kg-1 is of no particular interest but is well tolerated.

Adult↗
PubMed1983

[Postpartum cardiomyopathy attributed to the use of beta-mimetics].

A case of post-partum cardiomyopathy probably due to salbutamol is described. The patient was a young primipara without any cardiovascular disease. She presented a sudden left ventricular failure after Caesarean section for twins: salbutamol had not been given for a week. After 10 days' treatment with diuretics and vasodilators, the patient was cured, no sequellae remaining. It seemed the mechanism was multifactorial: direct myocardial injury, a reduction in the number of receptors, peripheral haemodynamic changes.

Adult↗