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Biomedical subjects

R Souron

Publications and source records attributed to R Souron.

At least 91 records · Page 5Linked to original sources

[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↗

[Influence of general anaesthesia on the position of the eyes during surgery of strabismus (author's transl)].

The position of the eyes during anaesthesia can help the diagnosis of mechanism of esotropia. 211 patients between 2 and 8 years old are planed for surgery of esotropia. They are anaesthetized with halothane. When surgical level of anaesthesia is obtained, the position of the eyes is looked for and thereafter the lateral rectus muscle of the eye is stretched for evaluation of its lengthening capacity. The results show that the correction of esotropia during anaesthesia is obtained in 46,4 p. cent of the cases. When esotrpia is corrected by anaesthesia, the stretching of the lateral rectus muscle is normal in 91 p. cent of the cases. So the position of the eyes during anaesthesia can let us to presume that anatomical anomaly of the muscle is absent and that a spasm of the muscle is involved.

Anesthesia, General↗

[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↗

[Ketamine anesthesia for definitive implantation of a cardiac pace maker (author's transl)].

An hemodynamic study has been performed in eight patients (age 68 +/- 7) suffering from complete atrioventricular block. They had to undergo the definitive implantation of a cardiac pace maker under general anesthesia. The fixed cardiac frequency may help to understand the effect of the anesthetic agent used on the cardiac muscle function. Ketamine is the only agent used directly at an initial intravenous dose of 3 mg.kg-1 followed by a perfusion in a constant rate of 0.20 mg.kg-1. min-1. Hemodynamic data (arterial pressure, pulmonary pressures, thermodilution cardiac output) are performed before induction, then every 5 minutes after induction for a 20 minute period. The absence of respiratory depression (PaCO2: 38 +/- 3 mm Hg) shows that hemodynamic changes are entirely due to ketamine. The peak of these changes takes place after 5 minutes (significant rise (p < 0.05) in systemic and pulmonary resistances, in systemic arterial pressure and in pulmonary arterial pressure). Stroke index decreases moderately. After 20 minutes all the parameters have returned to control values. Use of ketamine is not desirable for two reasons: 1 degree The rise of the afterload may alter the hemodynamic state which can be previously deteriorated in patients suffering from atrio-ventricular block. 2 degree Post-anesthetic agitation can displace the right ventricular electrode.

Aged↗

[Use of ventilation by oxygen injection in laryngeal microsurgery].

Thirty patients with a laryngeal polyp or other tumour, were operated on under the microscope. During the operation, which lasted from 10 to 30 minutes, ventilation was ensured by injection of oxygen at 3 to 4 atmospheric pressures through a naso-tracheal catheter. Anaesthesia was obtained by an association of propanidide, small doses of analgesic and succinycholine, constant rate syringes were used for maintenance of narcosis and curarisation. In 23 patients, blood gases were analysed at various stages of the operation permitting one to assess the quality of the ventilation carried out. In a few patients, it was also possible to record pressure curves in the trachea. The results were excellent, both concerning the quality of the ventilation and that of the anaesthesia together with the operative conditions. After recalling the main characteristics of this mode of ventilation which uses Venturi's principle, the authors expose the other methods which are variants compared with their technique of use of this procedure for laryngeal micro-surgery.

Adult↗