Search PubMed⌕ Search

Biomedical subjects

M Atmani

Publications and source records attributed to M Atmani.

17 recordsLinked to original sources

[Prevention of myoclonus after etomidate using a priming dose].

OBJECTIVE: To investigate the influence of pretreatment with a low dose of etomidate (priming dose) on the incidence of etomidate-induced myoclonus. STUDY DESIGN: Prospective randomized double-blind study. METHODS: Forty six patients ASA physical status I - II, scheduled for abdominal elective surgery, were allocated randomly to receive either pre-treatment 0.03 mg/kg of etomidate (priming group) or placebo (control group). Sixty-seconds after the pre-treatment was injected, anesthesia was induced with etomidate 0.3 mg/kg and 60 seconds later induction was completed with fentanyl (3 microg/kg) and vecuronium (0.1 mg/kg). The occurrence and intensity of myoclonus were graded clinically by a blinded observer as: 0=no myoclonus, 1=mild myoclonus, 2=moderate myoclonus and 3=severe myoclonus. STATISTICAL ANALYSIS: Fisher test exact for qualitative variable and Student t-test for quantitative variables. RESULTS: Demographic data and the average dose of etomidate used during the induction were similar in the 2 groups (0.29+/-0.032 mg/kg in the priming group and 0.30+/-0.029 mg/kg in the control group). Twenty patients (87%) in the control group experienced myoclonic movements whereas only 6 patients (26%) in the control group had such movements (P<0,001). CONCLUSION: Pretreatment with etomidate (0.03 mg/kg), given 60 seconds before induction of anesthesia, is effective at reducing etomidate-induced myoclonus, without related side-effect.

Aged↗

[Postoperative meningitis caused by an unusual etiological agent: Salmonella enteritidis].

Salmonella intracranial infections are unusual in adults, and particularly after neurosurgical procedures. We report a case of post-operative meningitis owing to Salmonella enteritidis. A 72-year-old man with type 2 diabetes was admitted to our unit for postoperative evaluation and management after neoplasic intracranial surgery. On the third day of admission, the patient developed infectious signs and diagnosis of postoperative meningitis was evoked. The cultivation of cerebrospinal fluid revealed Salmonella enteritidis which was also identified in several blood cultures. The treatment consisted of third-generation cephalosporin and quinolone to which Salmonella enteritidis was susceptible. However, the clinical course was poor and the patient died on day 8. This case demonstrates that postoperative meningitis can be caused by an unusual agent like Salmonella enteritidis.

Aged↗

[Peribulbar anesthesia: comparing 1% ropivacaine and a mixture of 0.5% bupivacaine--2% lidocaine].

PURPOSE: To compare the efficacy of 1% ropivacaine with a mixture of 0.5% bupivacaine and 2% lidocaine in peribulbar anesthesia for elective cataract surgery. MATERIAL AND METHODS: Prospective double-blinded study, enrolling 100 patients randomly assigned to two different groups. Group 1 received 9 ml of 1% ropivacaine and group 2 received 4.5 ml of 0.5% bupivacaine and 4.5 ml of 2% lidocaine. Both groups received 1 ml of hyaluronidase to reach a total volume of 10 ml. RESULTS AND CONCLUSION: No difference between the groups was noted during the study regarding not only onset time, but also the duration of anesthesia and perioperative analgesia. A greater incidence of pain on injection was significantly reported in group 2 (p<0.001). Patients in group 1 had less need for top-up injection and showed better ocular akinesia (p<0.01).

Aged↗

[Peri-bulbar anesthesia for cataract surgery].

Ninety-five peribulbar blocks for cataract extraction with intraocular lens implantation were performed by an anaesthetist over a period of 6 months. The quality of the block was assessed by the ophthalmologist and the anaesthetist. No dangerous local or systemic complications were observed. Peribulbar anaesthesia is increasingly preferred to retrobulbar block on account of its easiness and safety.

Aged↗

[Acute acalculous cholecystitis after digestive caustic burn].

A case is reported of acute acalculous cholecystitis in a patient who suffered a digestive burn treated by total parenteral nutrition. Pain in the right upper abdominal quadrant and fever occurred 26 days after the start of parenteral nutrition and 24 h after abruptly resuming oral feeding. Ultrasonography showed a distended gall-bladder with a thickened wall and the formation of sludge. Cholecystectomy was followed by a complete recovery. The part played by each of the corrosive burn, the total parenteral nutrition and the abrupt resumption of oral feeding in the pathogenesis of this complication is reviewed.

Acute Disease↗

[Percutaneous catheterization of the deep brachial vein].

50 attempts of deep percutaneous antecubital catheterization are reported. A tourniquet was applied to the upper arm and the medial deep brachial vein was punctured in a point immediately medial to the brachial artery, in the antecubital fossa. Venepuncture was successful in 88% of the cases (44 cases), catheterization possible in 72% of the cases (36 cases). The catheter reached the central venous compartment in 60% of the cases (30 cases). The only benign complication was injury to the brachial artery in 6 cases. Mean duration of catheterization was 20 days. This very easy and safe technique can be used when superficial veins are unusable and use of the deep central veins dangerous or impossible.

Adolescent↗

[Thrombosis of the superior vena cava in Behcet's disease. Apropos of a case associated with chylothorax].

The authors report a case of superior vena cava thrombosis associated to a chylothorax during Behcet's disease. This thrombosis was revealed during an evolutive phase by dyspnea and a superior vena cava syndrome. Its course was favourable under a medical treatment associating: pleural drainage, parenteral feeding, corticotherapy and heparin therapy. Then the authors review the bibliography and recall the frequency, pathogenesis, clinic and treatment of this unusual complication of the Touraine's aphthosis. Such a complication appears paradoxically to present a favourable course.

Adrenal Cortex Hormones↗