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Biomedical subjects

M Pinaud

Publications and source records attributed to M Pinaud.

At least 145 records · Page 8Linked to original sources
PubMed1982

[Comparison of the hemodynamic effects of fazadinium, pancuronium and alcuronium in coronary insufficiency (30 cases)].

Cardiovascular effects of neuromuscular blocking agents mainly guide the choice of these relaxants in patients with cardiovascular disease. The purpose of this study was to compare the hemodynamic effects of fazadinium (1 mg . kg-1), pancuronium (0,08 mg . kg-1) and alcuronium (0,2 mg . kg-1) in 30 coronary patients without beta-blocking therapy. No hemodynamic changes were observed after pancuronium. Fazadinium induced at the fifth minute a mean five p. 100 decrease in mean arterial pressure, cardiac index, stroke volume and systemic vascular resistance. At the fifth minute with alcuronium, mean arterial pressure decreased (22 p. 100) (p less than 0.01) with a decrease in cardiac index (12 p. 100), stroke volume (8 p. 100) and systemic vascular resistance (10 p. 100). This study shows that pancuronium and fazadinium are well tolerated. Alcuronium induces at the fifth minute a significant decrease in arterial pressure. This effect does not seem to be deleterious in normovolemic patient with coronary artery disease without beta-blocking therapy.

Aged↗
PubMed1982

[Fluid loading in the surgical care of pheochromocytoma. Hemodynamic study].

Collapse following removal of pheochromocytoma can be usually prevented by fluid loading. Fluid infusion is administered at the early beginning of the surgical procedure and is accelerated just after removal. Some authors prefer to start the fluid infusion in the preoperative period. In every cases preload measurements are of primary importance for a safely fluid administration. Problems of fluid loading in course of pheochromocytoma surgery are studied in six patients. Hemodynamic data are collected during pre, per and postoperative periods. Pre and post operative rapid fluid loading was performed in three patients in order to obtain a left ventricular function curve. Before any fluid treatment, two groups of patients are distinguished: 1) five hypovolemic patients who are about to receive 1 000 +/- 300 ml to normalize pulmonary wedge pressure, 2) one patient with high pulmonary wedge pressure and with alterated myocardial performance observed during rapid fluid loading. Combined use of sodium nitroprusside and fluid loading allowed to control hypertensive accesses and preload elevations and to prevent collapse following tumor removal. Hypovolemia and myocardial lesions are not necessarily present in all cases of pheochromocytoma. The routine use of a pulmonary artery catheter is warranted to improve cardiac pump function by combined fluid and vasodilator management.

Adrenal Gland Neoplasms↗
PubMed1981

[Sodium nitroprusside in ischaemic complications of acute ergot poisoning (author's transl)].

Various treatments have been tried against ischaemic complications of acute ergot poisoning, but no definite therapeutic approach based on a sufficient number of cases has yet been proposed. The mechanism of vascular spasm, the action of sodium nitroprusside and the good results obtained in 7 cases reported in the literature and in 2 personal cases have prompted the authors to suggest the use of this drug as first-choice treatment in these patients.

Acute Disease↗
PubMed1981

Comparison of effects of balanced anaesthesia and neuroleptanalgesia on postoperative cardiovascular function in patients with coronary artery disease.

Patients with chronic ischaemic heart disease and a history of myocardial infarction or who present with exertional or spontaneous angina suffer a decrease in left ventricular pump function during recovery from anaesthesia and in the period immediately after operation. This decrease is reflected in an increase in pulmonary capillary wedge pressure and in a decrease in stroke volume and cardiac output. Two groups of 10 such patients, clinically and haemodynamically comparable in the preoperative period, were studied: 10 patients received balanced anaesthesia, and 10 neuroleptanalgesia. The disturbance in left ventricular function was less pronounced with neuroleptanalgesia. A significant difference was noted between the groups with regard to pulmonary capillary wedge pressure during recovery from anaesthesia (balanced anaesthesia 15.8 +/- 4.4 mm Hg; neuroleptanalgesia 10.7 +/- 4.4 mm Hg; P less than 0.02). There was a relationship between type of anaesthesia and pulmonary capillary wedge pressure variations (P less than 0.01).

Abdomen↗
PubMed1981

[Anaesthesia with a constant rate perfusion of methohexital-fentanyl in neuro-radiological investigation (author's transl)].

Thirty-one patients undergoing neuro-radiological investigations were anesthetized by methohexital-fentanyl association. Induction of anesthesia was performed by I. V. bolus of these two agents. Anesthesia was maintained by a constant rate perfusion of methohexital and fentanyl, prepared according to body weight. Posology can be reduced hourly by modifying the perfusion rate. First hour: methohexital 2 mg/kg/hour fentanyl 5 microgram/kg/hour; second hour: methohexital 0.4 mg/kg/hour, fentanyl 2 microgram/kg/hour; third hour: methohexital 0,4 mg/kg/hour, fentanyl 1 microgram/kg/hour. If necessary this dosage was modified according to isolate reactions and thus total real consumption was 25 to 30 p. cent higher to estimated theoretical requirements. This protocol of anesthesia with controlled ventilation was well cardiocirculatory tolerated and adapted to these radiological investigations.

Anesthesia, Intravenous↗
PubMed1981

[Anaphylactoid shocks induced by infusion of a modified gelatin. Six cases (author's transl)].

One of these shocks occurred in course of a rapid infusion in a patient in whom catheters were previously inserted. So, an hemodynamic study was possible. This study shows a peripheral vasodilatation leading to a decrease of preload and cardiac output, and finally to a systemic hypotension which generally raises the alarm. These cases are the first anaphylactoid shocks reported after an infusion of modified gelatin. They demonstrate the general risk of anaphylactoid shock with all types of colloids.

Adult↗
PubMed1980

[Induction of anaesthesia. Haemodynamic incidence in patients with ischaemic myocardiopathy (author's transl)].

Haemodynamic incidence of induction of anaesthesia was evaluated in four groups of 10 patients in general surgery: patients without heart disease (gr. I), patients with ischaemic myocardiopathy (gr. II, gr. IV), patients with ischaemic heart disease who were digitalized before anaesthesis (gr. III). An anaesthetic technique comprising a combination of phenoperidine, thiopentone, suxamethonium, pancuronium, N2O/O2 was used in groups I, II, III and patients of group IV were anaesthetized with a protocol of narconeuroleptanalgesia (phenoperidine, droperidol, thiopentone, pancuronium, N2O/O2). Induction of anaesthesia in patient with ischaemic myocardiopathy leads to haemodynamic changes with a predominant decrease of mean arterial pressure. But the haemodynamic changes are less important with neuroleptanalgesia than with balanced anaesthesia. With neuroleptanalgesia decrease of mean arterial pressure is rather less important than with balanced anaesthesia and it is not coupled with a significant decrease of cardiac index but only with a decrease of total peripheral resistances. On contrary with balanced anaesthesia decrease of mean arterial pressure is connected with a significant decrease of cardiac index related to a decrease of systolic index. Pre-operative digitalization do not attenuate cardiac and haemodynamic changes occurring after induction and balanced anaesthesia. Though neuroleptanalgesia appears to be a safe technique in patients with ischaemic heart disease.

Abdomen↗
PubMed1980

[Perioperative cardiac arrhythmias in digitalized patients with ischemic heart disease (author's transl)].

The purpose of this study was to establish the incidence of pre-operative digitalization by intravenous digoxin on cardiac arrhythmias in 24 patients with ischemic heart disease who underwent abdominal surgery. Ambulatory electrocardiographic monitoring was performed for 12 hours before digitalization, for 12 hours during digitalization (before surgery), for the whole period of anesthesia. General anesthesia used thiopentone, phenoperidine, pancuronium and suxamethonium for endotracheal intubation. No more premature ventricular (PVC) and auricular contractions were detected after digitalization and during anesthesia and surgery. But PVC with begeminism or severe bradycardia were recorded in two patients and episodes of "torsades de pointes" occurred in two other patients during endotracheal intubation. "Torsades de pointes" have never been reported after suxamethonium and endotracheal intubation in digitalized patients. Digitalization, ischemic heart disease, cardiac effects of suxamethonium might be factors of the onset of these first reported "torsades de pointes". In conclusion, after a pre-operative digitalization in the coronary patients the frequency of arrhythmias is not exaggerated during the pre- or per-operative period except during induction and intubation. As the role of suxamethonium seems to be important as a trigger for severe arrhythmias endotracheal intubation in digitalized coronary patients should be performed without suxamethonium.

Acid-Base Equilibrium↗