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Biomedical subjects

R Souron

Publications and source records attributed to R Souron.

At least 73 records · Page 4Linked to original sources
PubMed1985

Bilateral phaeochromocytomas in pregnancy: anaesthetic management of combined caesarean section and tumour removal.

A 25-year-old primigravida with bilateral phaeochromocytomas was managed from 6 weeks' gestation until 2.5 years following combined Caesarean section and removal of adrenal tumours. Pre-operative alpha-blockade was achieved by oral prazosin without deleterious effects. Intra-operative management comprised neuroleptanalgesia, arterial and pulmonary pressure monitoring, adequate heart loading with fluid replacement and sodium nitroprusside. Post-operatively, mother and baby remained normotensive.

Adrenal Gland Neoplasms↗
PubMed1985

[Preoperative vascular loading. A guide for the management of volume expansion in the surgery of pheochromocytoma].

The most acurate fluid replacement is needed for the operative management of patients with pheochromocytoma. Pulmonary capillary wedge pressure monitoring must be incorporated into routine practice for assessing left ventricular filling pressure because discrepancies between central venous pressure and left-sided filling pressure may occur, even in patients apparently free of cardiopulmonary dysfunction. The response to preoperative acute volume loading was used in 11 patients--to detect preoperatively patients in whom fluid infusion was associated with a dangerous increase in pulmonary wedge pressure without improvement in forward flow and--to provide a guide for intraoperative volume replacement. This method confirmed informations suspected from baseline pressure data in one patient: distorsion between right and left ventricular filling pressures. Furthermore it showed an unsuspected ventricular dysfunction in a second patient with normal baseline pulmonary capillary wedge pressure. Both volume and speed of operative fluid challenge were adapted to this preoperative ventricular response.

Adrenal Gland Neoplasms↗
PubMed1984

[Pneumomediastinum and subcutaneous emphysema after translaryngeal jet ventilation].

The use of emergency transtracheal jet ventilation in a 62 year-old female with laryngeal papillomatosis and respiratory distress is reported. Adequate ventilation of the lungs with an intermittent jet of oxygen under high pressure (5 bar) allowed anaesthesia and surgery to be carried out. Pathogenesis of the mediastinal and subcutaneous emphysema discovered at the end of the procedure is discussed.

Airway Obstruction↗
PubMed1984

[Postoperative respiratory complications of myotonia dystrophica (Steinert's disease)].

Respiratory difficulties have long been recognized to be a major risk in patients with myotonia dystrophica, but postoperative pulmonary complications have only rarely been considered. Two cases of postoperative pulmonary complications which led to the patients's death stressed the severity and difficulty of treatment of these complications. A third case of postoperative respiratory failure revealed the underlying disease. These cases showed all the more the importance of preventing pulmonary complications. Pre-, per- and postoperative measures, chosen with respect to the severity of the myotonia and the seat of the surgical procedure, are suggested.

Adult↗
PubMed1984

[Anesthesia protocol in the swine. Effects of bleeding on circulation and acid-base equilibrium].

Haemodynamic parameters and their variations after the loss of 250 and 500 ml of blood under anaesthesia were studied in nine, 11 to 12 week-old, domestic swine weighing 37.4 +/- 2.6 kg. Premedication consisted of 2 ml azaperone i.m. Anaesthesia was induced with thiopentone, followed by suxamethonium to allow the easy placement of a cuffed endotracheal tube. Anaesthesia was maintained with phenoperidine and pancuronium. The animals were mechanically ventilated with a 50/50 nitrous oxide-oxygen mixture. A catheter was inserted in each of the femoral artery, upper hepatic vein, vena cava and portal vein. Right atrial, pulmonary and wedge pressures were measured; stroke volume, systemic and pulmonary resistances were calculated (fC 90 c X min-1, Pa 82 mmHg, Pra 4.7 mmHg, Ppa 24 mmHg, Ppw 11.6 mmHg, Q 4.45 l X min-1 and Rsa 1460 dyn X s X cm-5). The swine were then bled. After a bleed of 250 ml (t1), the haemodynamic parameters were significantly modified. After another bleed of 250 ml (t2), the heart rate only was significantly higher than at t1; but the blood transfusing could not re-establish a normal haemodynamic state. Blood samples were obtained to measure pH and total CO2 in a systemic artery, and the upper hepatic veins, vena cava and portal vein: the results suggested that the liver took part in the removal of acid metabolites.

Acid-Base Equilibrium↗
PubMed1984

[Peroperative autotransfusion].

Intraoperative autotransfusion was used in 15 patients undergoing peripheral vascular, porta-caval and liver surgery. This technique is blood saving in these indications. The most important physiopathological consequence is disseminated intravascular coagulation, whatever anticoagulation protocol is used. Low-dose heparin continuously administered is considered.

Acute Kidney Injury↗
PubMed1984

Pharmacokinetics of intravenous and intramuscular methohexitone in dogs.

Twenty-four dogs received methohexitone, either intravenously injected (2 mg kg-1 of a 1% solution) or intramuscularly (10 mg kg-1 of a 2% solution). Plasma methohexitone concentrations were measured by gas/liquid chromatography and pharmacokinetics were obtained from the general equations of a multicompartment model. Peak blood concentrations were equivalent following i.v. (18.2 +/- 9.9 mg 1(-1); at 30 s) and i.m. (19.1 +/- 5.6 mg 1(-1); at 3 min) injections. After i.v. injection a rapid distribution phase (half-life t 1/2 lambda 1; 1.3 +/- 0.5 min) was followed by an elimination phase (elimination half-life t 1/2 lambda z; 26.4 +/- 7.8 min). After i.m. injection the distribution phase was followed by two further phases (half-lives: 10.1 +/- 3.6 min and 75.6 +/- 22.6 min). The authors conclude that an i.m. dose five times as great as the i.v. dose produces equivalent peak blood concentration 30 s after i.v. injection and 3 min after i.m. injection. In addition, after i.m. injection of 10 mg kg-1 an additional compartment was apparent, indication substantial drug uptake by poorly perfused tissues.

Animals↗
PubMed1984

[Anesthetic aspects of the primary treatment of labio-maxillo-palatal clefts].

This study of 97 operations discusses our anaesthetic experience for labio-maxillary clefts and the problems which arise for the anaesthetist during pre-inter and post surgical periods. This type of functional surgery is carried out on children between 4 and 23 months old, of which 22% presented with associated malformations. Paediatric anaesthetic characteristics in a maxillo-facial context are discussed in detail. We indicate the importance of installing the different surveillance elements before placement of the surgical fields. We treat the problems of drug interactions between the halogenic anaesthetics and vasoconstrictor used for local haemostasis, the limits of spontaneous ventilation and the secondary metabolic consequences of prolonged fasting.

Abnormalities, Multiple↗
PubMed1983

[Electroencephalographic study of pediatric anesthesia with intramuscular methohexital].

Intramuscular methohexital was used in pediatric anesthesia to carry out special investigations. There seemed to be few side effects but twitches or seizures have been reported. An electroencephalographic study was performed in normal children. The electroencephalogram showed periods of increased amplitude. The authors discussed the problem of side effects following the intramuscular administration of methohexital in the normal child, and prescribed its use in the epileptic.

Anesthesia, General↗
PubMed1983

Influence of cardiac rhythm on the haemodynamic effects of fazadinium in patients with heart failure.

The haemodynamic effects of fazadinium were compared in two groups of elderly patients with class III functional heart failure about to undergo gastrointestinal surgery. Four patients were in sinus rhythm and four in atrial fibrillation. Following the assessment of baseline values fazadinium 1 mg kg-1 was injected i.v. and measurements obtained every 1 min for 15 min. In patients in sinus rhythm, fazadinium produced a decrease in total peripheral resistance, which was maximum at the 1st min (delta TPRI -738 +/- 88 dyn s cm-5 m2) and accompanied by a moderate decrease in arterial pressure (MAP -27 +/- 2.4 mm Hg) and cardiac index (delta CI -0.23 +/- 0.17 litre min-1 m-2) and a moderate increase in heart rate (delta HR +16 +/- 5.7 beat min-1). In patients in atrial fibrillation, a similar decrease in total peripheral resistance (delta TPRI -1160 +/- 174 dyn cm-5 m2) was accompanied by a significantly more pronounced tachycardia (delta HR +71 +/- 5.1 beat min-1) (P less than 0.001) and decreases in arterial pressure (delta MAP -51.7 +/- 5.9 mm Hg) (P less than 0.01) and stroke index (P less than 0.02).

Aged↗
PubMed1983

Echocardiography and left ventricular function on recovery from anaesthesia in patients with coronary artery disease.

Eight patients with coronary artery disease and eight age-matched patients without coronary artery disease undergoing noncardiac surgery were submitted to M-mode echocardiography and haemodynamic measurements. In the patients with coronary artery disease, but not in the controls, recovery from anaesthesia was associated with echocardiographic and haemodynamic changes suggestive of impaired cardiac pump function. This impairment seems to result from an imbalance between myocardial oxygen availability and demand in patients with coronary artery disease.

Acid-Base Imbalance↗
PubMed1982

[Electroclinical aspects of intramuscular methohexital anesthesia in children].

Intramuscular methohexital is used in children for short-term anaesthesia. As a seizure was observed in two of our cases after administration of this barbiturate, an EEG study was performed. The EEG pattern was characterized by a particularly slow, sharp, high voltage stage with a decrease of fast rhythms (stage 3a), then fast and sharp rhythms becoming more and more frequent (stage 3b). These stages were particularly pronounced and prolonged in children over 3 years of age, with myoclonic jerks observed in 6 cases, beginning about 3 min after methohexital injection and at the same time as the clinical seizures. These results are discussed in terms of previously reported descriptions of barbiturate anaesthesia, and especially of i.m. or i.v. methohexital anaesthesia. This anaesthetic, although reliable and easy to use, should in our opinion be avoided in epileptic children.

Anesthesia, General↗
PubMed1982

[Development of blood sugar and insulinemia in the first 12 postoperative hours. Effects of glucose and insulin intake].

Serum levels of glucose and insulin are studied during 12 hours in the early post-operative period after intra-abdominal surgery. Five groups of non diabetic patients are perfused with incremental doses of glucose, G. I: no glucose, G. II: 8,33 g . h-1 of glucose during 6 hours, G. III: 16,66 g . h-1 of glucose during 6 hours, G. IV: 16,66 g . h-1 of glucose with 20 mu insulin; G. V: 16,66 g . h-1 of glucose with 40 mu insulin. In all groups a significant rise in serum levels of glucose is observed (10,5-15,6 mmol . l-1). At the same time serum level of insulin remains unchanged except when insulin is infused. However exogenous insulin is unable to prevent the serum level of glucose to rise post-operatively.

Adult↗
PubMed1982

[Caudal anesthesia in infants and children].

Caudal analgesia may be used with general anaesthesia in painful surgery. Caudal anaesthesias were performed by the authors, as the single anesthetic technic for digestive or orthopedic surgery in nine children. The technic is sure, efficient and without any complications. Caudal anaesthesia seems to be interesting in the child with respiratory pathology or with morphologic facial abnormalities.

Anesthesia, Caudal↗
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↗