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Biomedical subjects

P Pere

Publications and source records attributed to P Pere.

59 records · Page 4Linked to original sources
PubMedDate not supplied

[Fractures caused by bony insufficiency of the sacrum. Clinical, radiographic, scintigraphic and x-ray computed tomographic symptomatology].

Fracture of sacrum due to bone deficiency is not a rare lesion and must be considered as a possible differential diagnosis of unexplained pelvic region pain. The various clinical semeiology elements are discussed in relation of 20 cases, together with circumstances of onset, enabling definition of a population at risk: elderly women with a bone metabolic disorder and/or a congenital or acquired architectural anomaly. Radiographic, scintigraphic and CT scan images are sufficiently characteristic for these non-invasive exploratory procedures to provide an exact diagnosis and the possibility of early treatment.

Aged↗
PubMedDate not supplied

Local myotoxicity of bupivacaine in rabbits after continuous supraclavicular brachial plexus block.

BACKGROUND AND OBJECTIVES: Local anesthetics including bupivacaine have been known to be myotoxic. Continuous brachial plexus blocks with bupivacaine provide good postoperative pain relief, but their effects on the surrounding muscles have not been studied. METHODS: Eight rabbits were given continuous bilateral brachial plexus blocks with 0.25% bupivacaine (BUPI) and another eight (SALINE) equivalent volumes of saline infused into the plexus region under pentobarbital-ketamine sedation. At the end of the 24-hour blocks, muscle biopsies were taken from one side of the neck in both groups. A week later, the biopsy procedure was repeated on the other side. Plasma concentrations of bupivacaine were measured before and at the end of the 24-hour blocks. RESULTS: Inflammatory cell infiltration and muscle fiber necrosis were significantly more common in the BUPI than in the SALINE group (p < 0.001). At the end of the continuous block, predominantly neutrophils were found, but in the BUPI group large amounts of eosinophilic granulocytes also were found. A week later lymphocytes, plasma cells, macrophages, and fibroblasts were seen as a sign of beginning scar formation. Plasma concentrations of bupivacaine at 24 hours were at a nontoxic level (0.28-0.71 microgram/ml). CONCLUSIONS: Brachial plexus blocks with bupivacaine caused reversible myotoxicity and inflammation in the rabbit. A week after the continuous blocks, muscle fiber regeneration had already started.

Animals↗
PubMedDate not supplied

The effect of continuous interscalene brachial plexus block with 0.125% bupivacaine plus fentanyl on diaphragmatic motility and ventilatory function.

BACKGROUND AND OBJECTIVES: Continuous interscalene brachial plexus block with 0.25% bupivacaine decreases diaphragmatic motility and ventilatory function. The author studied the effects of 0.125% bupivacaine with and without fentanyl. METHODS: Forty patients who were to undergo shoulder surgery were given an interscalene brachial plexus block using 20-28 ml 0.75% bupivacaine plus epinephrine. In random order, 10 patients then had a 24-hour continuous block with 0.125% bupivacaine (BUPI) (5-9 ml/h). Nine patients had an additional s.c. infusion of fentanyl (F-SC) (15-27 micrograms/h) and 10 the same dose of fentanyl with the bupivacaine infusion (F-PLX). Ten patients had a single block (PLX) for minor surgery. Spirometry, double-exposure chest radiography, pulse oximetric hemoglobin saturation and maximal airway pressures were measured. RESULTS: Postoperatively, BUPI patients were given, on average, 1.2, F-SC patients 0.7, and F-PLX patients 0.4 doses of oxycodone in 24 hours (not significant). Average ipsilateral diaphragmatic motility was reduced to 8% in F-PLX group (p < 0.01) and to 19-30% in the other groups (p < 0.05). At 24 hours, average motility in BUPI, F-SC, F-PLX and PLX groups was 54, 48, 31 and 91%, respectively. In all groups FVC, FEV1 and PEF were reduced by 20-40% at 3 hours (p < 0.001). At 8 and 24 hours, FVC and FEV1 were in F-SC and F-PLX groups significantly lower (p < 0.05) than in PLX group. CONCLUSIONS: Use of 0.125% bupivacaine for continuous interscalene block did not prevent a deterioration of diaphragmatic motility and ventilatory function. Co-infusion of fentanyl did not significantly potentiate the block.

Adult↗