Search PubMed⌕ Search

Biomedical subjects

P Veyrac

Publications and source records attributed to P Veyrac.

5 recordsLinked to original sources

[Chronic tinnitus and hearing loss caused by cerebrospinal fluid leak treated with success with peridural blood patch. Apropos of 2 cases].

Hearing loss and tinnitus are frequently encountered in ENT patients and usually require complementary investigations such as audiogram, auditive evoked potentials, CT scan, MRI... One recent etiology, that is more and more discovered, is a decrease in spinal fluid pressure secondary to a dural fluid leak that occurs after a diagnostic lumbar puncture, a spinal anesthesia, an accidental dural puncture during an epidural technique or a lumbar myelography. Postural headache which are frequently present in such a setting, may mask these auditive symptoms. Epidural injection of autologous blood (blood patch) performed by anesthesiologists, which is usually indicated to treat such postural headaches, is efficient in relieving other symptoms related to spinal fluid leak after dural puncture. We report two cases of isolated auditive complaints (hearing loss and tinnitus) which have been dramatically improved after blood patch. In conclusion, ENT surgeons should seek for a recent or even a past history of spinal puncture whenever the etiology of auditive symptoms of their patient remains unclear.

Adult↗

[A traditional anesthesia consultation or a "telephone interview" within the framework of ambulatory surgery?].

UNLABELLED: Preoperative assessment for anaesthesia must detect in the setting of ambulatory surgery both medical and sociopsychologic problems which may contraindicate the ambulatory aspect of the procedure. The goal of our prospective study was to assess the efficacy of a preoperative telephone interview in screening the medical and sociopsychologic problems of ambulatory patients. 1,000 consenting consecutive outpatients participated to the study and were randomly allocated to one of two groups: patients in the standard group (STD) had a consultation a few days before surgery whereas those in the telephonic group (TEL) called the anesthetist a few days before, the physical exam being performed on the day of surgery. The cancellation of the ambulatory procedure was decided upon either medical criterias (MC) or sociopsychologic criterias (from Waetchler). RESULTS: both groups were comparable regarding SPC and MC but prescription of preoperative tests was more frequent in the STD group (result statistically significant). In conclusion, this new approach is as reliable as the standard consultation in screening the SPC which remain the most frequent cause of cancellation in ambulatory surgery. Therefore this telephonic interview which is simple and reliable for screening outpatients may represent a suitable alternative to a standard consultation.

Ambulatory Surgical Procedures↗

Reversal of hypoxia-induced decrease in human cardiac response to isoproterenol infusion.

A decrease in heart rate response to isoproterenol (IP) infusion has been previously described in humans exposed to acute (2-3 days) or chronic (21 days) exposure to altitude hypoxia (J. Appl. Physiol. 65: 1957-1961, 1988). To evaluate this cardiac response in subacute (8 days) hypoxia and to explore its reversal with restoration of normoxia, six subjects received an IP infusion under normoxia (condition N), after 8 days in altitude (4,350 m, condition H8), on the same day in altitude after inhalation of O2 restoring normoxic arterial O2 saturation (SaO2, condition HO), and 6-11 h (condition RN) and 4-5 mo (condition ND) after the return to sea level. Cardiac chronotropic response to IP, evaluated by the mean increase in heart rate from base value (delta HR, min-1), was lower in condition H8 [mean 30 +/- 13 (SD)] than in condition N (50 +/- 14, P less than 0.03); it was slightly higher in condition HO (38 +/- 14) or condition RN (42 +/- 15) than condition H8 but still significantly different from condition N (P less than 0.03), despite normal values of SaO2. delta HR in condition ND (55 +/- 10) returned to base N value. These findings confirm the hypothesis of a hypoxia-induced decrease in cardiac chronotropic function. Two possible mechanisms are suggested: an O2-dependent one, rapidly reversible with recent restoration of normoxia, and a more slowly reversible mechanism, probably a downregulation of the cardiac beta-receptors.

Adult↗