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Biomedical subjects

M Cavellat

Publications and source records attributed to M Cavellat.

At least 19 recordsLinked to original sources
PubMed1991

[Effect of continuous barbiturate treatment on the blood flow of the mean cerebral artery in severe brain injured patients. A transcranial Doppler study].

Blood flow velocity (BFV) of the MCA has been studied by TCD of 15 patients with non operated serious cranial trauma, treated with continuous barbiturate therapy. Without hemodynamic and ventilatory modifications (PaCO2), average BFV were lowered during the course of treatment and were raised significantly when it was stopped. This study poses the question of the indication and the methods of barbiturate treatment during serious cranial trauma.

Adult↗
PubMed1989

[Treatment of postoperative pain in children in the recovery room. Use of morphine and propacetamol by the intravenous route].

The analgesic efficiency of morphine and propacetamol for postoperative pain, in the recovery room, was studied in two groups of children, who had undergone either orthopedic or visceral surgery. An injection of 50 mcg/kg of morphine chlorhydrate was given to the first group of 239 children ASA I, who were admitted to the recovery room and who presented signs of severe pain (agitation, crying, complaining). The analgesic efficiency of morphine was judged on physiological criteria (blood pressure, heart rate) and on behavioral criteria (calming of the child). No incidents were noticed. A second study was then performed on a second group of 100 children ASA I, who received 15 mg.kg-1 of propacetamol as an intravenous perfusion for 15 minutes. The analgesic efficiency of propacetamol was judged on behavioral criteria alone. In the morphine group, 67% of the children was calmed following one injection (94% after a second injection given 15 minutes after the first). In the propacetamol group, 77% of the children were calmed. Propacetamol was insufficient for the pain in 23% of the cases but one subsequent injection of morphine was always sufficient to calm the child. These two successive studies show the need for an analgesic protocol for children in the recovery room. Propacetamol should be administered first and then, if insufficient, followed by only one injection of morphine. This protocol of propacetamol and morphine seems to be satisfactory and thus avoids all pernicious side effects.

Acetaminophen↗
PubMed1988

[Evaluation of the efficacy and tolerance of flumazenil in antagonism of the effects of flunitrazepam on the central nervous system].

The efficacy and tolerance of flumazenil were assessed in a double-blind randomized multicentre trial on 120 ASA I or II patients aged 40.3 +/- 13.9 years. They were anaesthetized with flunitrazepam (25.1 +/- 10.5 micrograms.kg-1.h-1), fentanyl (4.4 +/- 1.9 micrograms.kg-1.h-1) and either vecuronium or pancuronium; residual neuromuscular blockade was antagonized at the end of surgery. 61 patients received flumazenil and 59 a placebo. Sedation comprehension and temporo-spatial orientation were scored at 0, 5, 15, 30, 60, 120 and 240 min after the administration of flumazenil or placebo. Local and general tolerances were evaluated 1 h and 24 h after administration. At the 24th h, the observer's assessment of consciousness, pain, respiration, coughing and vomiting were noted, as well as his identification, or not, of flumazenil or the placebo and their efficacy. Both groups were statistically homogeneous and comparable. Significant and marked efficacy was noted between the 5th and 30th min. There was no difference, at 24 h, between the flumazenil and placebo groups. In most cases, flumazenil was identified by the observer and its efficacy felt to be excellent. No major untoward effect of flumazenil was noted; however a mild and short lasting anxiety occurred in three patients. Tolerance was deemed to be excellent.

Adolescent↗
PubMed1988

[Final arrest of a pacemaker after use of electrocautery].

A case is reported of irreversible damage being caused to a permanent programmable pacemaker by electrocautery used in the epigastric region. The pacemaker was rapidly replaced, and the patient had no adverse effects of this accident. The use of monopolar electrocautery in patients who have one of the new generation of programmable pacemakers is very dangerous. Bipolar forceps can reduce the level of interference between electrocautery units and pacemaker electrodes. With programmable pacemakers, the generator instruction manual should be consulted before surgery, as placing a magnet on the generator may not necessarily convert it to the asynchronous mode. When the use of electrocautery is unavoidable, external cardiac pacing electrodes should be placed on the patient, with an external cardiac pacemaker ready.

Cardiac Pacing, Artificial↗
PubMed1987

Pharmacokinetics of ornidazole in neonates and infants after a single intravenous infusion.

The single dose pharmacokinetics of ornidazole has been evaluated in 12 neonates or infants (aged 1 to 42 weeks) after the infusion of 20 mg/kg over 20 min. Plasma disposition was described by a two-compartment open model. The distribution phase was short (T1/2 (1) = 0.31 h) and was followed by an elimination phase (t1/2 (2) = 14.67 h). The mean apparent volume of distribution was 0.961/kg-1. These results did not differ from data previous by reported in adults. Total plasma clearance was between 0.4 and 1.4 ml X min-1 X kg-1. The plasma concentration 24 h after the infusion was 7.32 mg X l-1, which was above the minimum inhibitory concentration for clinically significant anaerobic bacteria. Based on the pharmacokinetic results and residual concentrations at 24 h, a single daily infusion of ornidazole 20 mg X kg-1 appears adequate for therapy in neonates and infants.

Chromatography, High Pressure Liquid↗
PubMed1987

[Propofol in urological endoscopy in elderly patients. Comparison with methohexital].

Twenty patients undergoing cystoscopy (group A) and forty patients undergoing transurethral resection (group B), aged more than 65 years, were anaesthetized. Duration of anaesthesia was less than 15 min for cystoscopy, and more than 30 min for transurethral resection. No premedication was given. The patients were ASA I or ASA II. Group A patients were allocated randomly to receive either 1.5 mg . kg-1 propofol (n = 10) or 2 mg . kg-1 methohexitone (n = 10) for induction of anaesthesia. Anaesthesia was maintained using incremental doses of propofol or methohexitone and 60% N2O with a face-mask. Forty group B patients undergoing transurethral resection were randomly assigned to four equal groups (PB: propofol 1.5 mg . kg-1; MB: methohexitone 2 mg . kg-1; PF: propofol and 1.5 micrograms . kg-1 fentanyl; PFV: propofol, 2 micrograms . kg-1 fentanyl and 0.1 mg . kg-1 vecuronium). Suxamethonium (1 mg . kg-1; groups PB, MB and PF) and vecuronium (0.1 mg . kg-1; group PFV) were given to facilitate endotracheal intubation. Anaesthesia was maintained by infusion of propofol or methohexitone, using a calibrated pump started immediately after intubation. Ventilation was controlled only in group PFV. Induction with 1.5 mg . kg-1 propofol resulted in stopping counting after 62 s and loss of the eye-lash reflex after 84 s versus 47 and 67 s respectively with methohexitone. The anaesthesist's assessment was favourable for cystoscopy with propofol and methohexitone; recovery times were similar for the two drugs in cystoscopy lasting less than 30 min.(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗
PubMed1987

[Hemodynamic effects of intranasal nifedipine during clamping of the abdominal aorta].

The haemodynamic changes due to cross-clamping of the abdominal aorta below the renal arteries were studied in ten patients. Anaesthesia was induced with thiopentone and maintained with fentanyl and vecuronium and inhalation of 60% nitrous oxide in oxygen. At the fifth minute, clamping increased mean arterial pressure (Pa) by 11%, systemic vascular resistance (Rsa) by 26% and decreased cardiac output (CO) by 20%. Nifedipine was administered intranasally at this time. Heart rate remained unchanged; mean pulmonary arterial and mean pulmonary wedge pressures were slightly decreased. Pa and Rsa fell to significantly lower levels between the fifth and fifteenth minutes (24 and 43% respectively). Although CO increased by 28%, this was not significant. The administration of intranasal nifedipine during anaesthesia was well tolerated. This study demonstrated that intranasal nifedipine prevented adverse haemodynamic effects of cross-clamping of the aorta below the renal arteries.

Administration, Intranasal↗
PubMed1987

[Determination of thresholds of external cardiac pacing during anesthesia].

The efficacy of transcutaneous pacing was studied in 33 patients during general anaesthesia. The temporary pacing was effective in all cases. Stimulation thresholds ranged from 85 to 150 mA (mean : 110 +/- 17). In all 33 patients, external pacing was effective in producing a pulse without significantly reducing arterial pressure. Stimulation thresholds were only influenced by electrode position; age, weight, thoracic diameter and cardiothoracic ratio did not have any effect on them. No adverse effects of transcutaneous pacing were recorded. Transcutaneous pacing can be an alternative to transvenous right ventricular endocardiac pacing in the operating room in some circumstances.

Aged↗
PubMed1986

[Pharmacokinetics of thiopental in women and newborn infants].

Plasma thiopentone concentrations after a single intravenous dose were determined by high pressure liquid chromatography in female surgical patients (n = 13), in pregnant women at term (n = 13) and in neonates (n = 13). In pregnant women, the apparent volume of distribution (Vd = 10.02 +/- 3.26 l X kg-1), plasma clearance (Cl = 22.03 +/- 7.55 l X h-1) and elimination half-life (t 1/2 (3) = 21.71 +/- 11.12 h) were significantly greater than in the surgical patients (Vd = 4.22 +/- 1.16 l X kg-1; Cl = 12.49 +/- 3.50 l X h-1; t 1/2 (3) = 13.79 +/- 3.09 h). Elimination half-life in neonates (t 1/2(e) = 17.9 +/- 9.7 h) was not different from half-life in mothers or in the surgical group. At delivery, the simultaneous concentrations were 5.3 +/- 1.3 mg X l-1 in venous blood and 3.8 +/- 1.6 mg X l-1 in cord venous blood. Apgar score was 10 in eleven neonates. For two babies, an Apgar score at 6 was explained by a uterine incision-to-delivery time interval greater than 2 min.

Adult↗
PubMed1985

[Anti-arrhythmia effects of magnesium salts. 4 cases].

Known since 1935, the antiarrhythmic effects of magnesium salts are periodically forgotten. They are illustrated here by 4 cases with entirely different clinical and biological features. Of unquestionable therapeutic value was the use of magnesium for the treatment of 2 episodes of severe ventricular extrasystoles with "torsades de pointe". These antiarrhythmic properties are observed whether blood magnesium levels are normal or low and cannot therefore be ascribed to correction of magnesium deficiency. Experimental data are in favour of interferences with transcellular ion flows. Magnesium is thought to ensure normal potassium gradient and also to reactivate the fast sodium channel inhibited by hypokalaemia. Above all, the magnesium ion appears to act as a calcium inhibitor, which would explain its antiarrhythmic properties irrespective of the state of magnesium body stores.

Adult↗
PubMed1983

[Endobronchial hemostasis with a Fogarthy catheter].

In a case of profuse and persistent traumatic haemoptysis uncontrolled by thoracotomy, haemostasis was achieved by introducing a Fogarthy's catheter under bronchoscopy into the bronchus involved. Some practical details facilitating the procedure are given, e.g. a rigid bronchoscopic tube should be used instead of a fiberoscope; the catheter should be introduced between the vocal cords along the tube and not inside it.

Adult↗