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Biomedical subjects

O Bastien

Publications and source records attributed to O Bastien.

84 records · Page 5Linked to original sources
PubMed1986

[Hemodynamic and effects of preoperative sedation with the diazepam-droperidol combination].

Central venous or pulmonary arterial catheterisations under local analgesia before induction of anaesthesia may act as noxious stimuli likely to increase systemic arterial pressure and cardiac rate. This prospective study aimed to assess the value of an association of diazepam and droperidol for sedation, so as to prevent such haemodynamic disturbances. Fifty consecutive patients, 58 +/- 1.4 years old, most of them with severe cardiac disorders, were given an oral premedication which consisted of diazepam, 10 mg, with cimetidine, 200 mg, the previous evening, and diazepam (0.3 mg X kg-1) with cimetidine (400 mg) two hours before surgery. In the operation theatre, before central venous catheterisation, they received intravenous diazepam, 5 mg or 10 mg, according to their state of sedation at the time, and droperidol, 5 mg or 10 mg, according to systemic arterial pressure. In all cases, central venous catheterisation was performed under good conditions. Both systolic and diastolic pressures decreased by 11.65% and 10.10% respectively; cardiac rate was unchanged, while PaO2 decreased by 6.36% and PaCO2 increased by 4.97%. Severe transient hypoxaemia occurred in one 72-year old patient but without further clinical complication. Thus, this type of pre-operative sedation appears to be satisfactory, provided that the dose of i.v. diazepam does not exceed 5 mg in the elderly.

Blood Pressure↗
PubMed1985

[Cardiogenic shock].

Explore the source record for details and available documents.

Diagnosis, Differential↗
PubMed1984

[Anesthesia with flunitrazepam/fentanyl in the severe coronary patient. Hemodynamic study].

Twenty three patients on class 3 or 4 NYHA were anesthetized with flunitrazepam 30 micrograms/kg. fentanyl 20 micrograms/kg, N2O for coronary bypass surgery. Hemodynamics data before and after induction reveal a 30% fall of cardiac index with stability of systolic vascular resistance. This higher value refer to literature on flunitrazepam. The clinical association with N2O and fentanyl can explain negatively inotropic effect. The bad ventricular function of this patients is probably the cause of a underestimate vascular filling.

Aged↗
PubMedDate not supplied

[New morphine-type analgesics in anesthesia].

Since the synthesis of Fentanyl in 1961, many narcotics have appeared which are not yet available in France. Among agonists, all are Fentanyl derivates but are different by either more powerful (sufentanyl, lofentanyl), and longer-acting effects (lofentanyl), or less powerful and shorter-acting effects (alfentanyl). All would have a greater security index and minimal cardiovascular side effects. Among agonists-antagonists, only pentazocine is available in France for analgesic therapy. The interest of other new molecules as butorphenol, nalbuphine and buprenorphine, which are available in other countries, still remains a matter of discussion.

Alfentanil↗
PubMedDate not supplied

[Is it necessary to discontinue captopril before heart surgery?].

Interaction between kininase II and anaesthesia is not well described. Twenty two patients treated by kininase II for congestive heart failure are studied during anaesthesia for cardiovascular surgery. A first group of seventeen homogeneous hemodynamic data are reported. High cardiac index contrasts with severe clinical cardiac failure. A second group of inhomogeneous patients are separately described. Vasoconstrictor can be codified in the situation of low systemic resistance with high cardiac index. Preoperative treatment can be continued, under requirement of hemodynamic monitoring.

Anesthesia, General↗
PubMedDate not supplied

[Treatment of low cardiac output following extracorporeal circulation with captopril].

Seven patients in low-output cardiac failure, resistant to conventional vasodilators and inotropic agents, following surgery with extra-corporeal circulation were given oral captopril, an angiotensin converting enzyme inhibitor. The effects of captopril on haemodynamic and renal function were studied after 2, 6, 12 and 24 hours of treatment. After two hours, there was a mean reduction in systemic arterial resistance of 29%, in pulmonary arterial resistance of 18% and in pulmonary wedge pressure of 15%. The mean increase in the cardiac index was 28%. This marked initial haemodynamic improvement was either maintained or increased over the rest of the 24 hours. By 24 hours there had been a mean increase in urinary sodium excretion of 200%. The urinary sodium/potassium ratio increased from 0.62 to 1.45. Oral captopril thus seems suitable for treating low-output cardiac failure following surgery requiring extra-corporeal circulation.

Adult↗