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Biomedical subjects

Y Gozal

Publications and source records attributed to Y Gozal.

50 records · Page 3Linked to original sources
PubMed1992

[Comparative study of conventional spinal anesthesia and combined spinal-epidural anesthesia in gynecological surgery].

A prospective study was carried out to compare the qualities of spinal block with those of combined spinal-epidural anaesthesia (CSEA). It included 63 patients, ranked ASA 1 or 2, aged between 35 and 75 years, scheduled for gynaecological surgery due to last more than 2 hours, and randomly allocated to two groups. In the first group (n = 34), spinal anaesthesia was carried out with the patients sitting, in the L3-4 interspace, using 15 mg of hyperbaric bupivacaine with 0.4 mg of adrenaline. In the second group (n = 29), a catheter was inserted in the epidural space through the L2-3 interspace, and spinal anaesthesia carried out as in the first group, using bupivacaine without adrenaline. Once the highest level of analgesia had been reached, aliquots of 0.5% plain bupivacaine were injected through the epidural catheter, until anaesthesia of T5 was obtained. In the spinal group, general anaesthesia was required in 3 cases, as anaesthesia only reached the T12 level in 2 cases, and as surgery lasted longer than the spinal in the third one. In the CSEA group, excellent analgesia was obtained in all patients. Sensory blockade lasted 308 +/- 48 min at the T12 level, versus 162 +/- 51 min in the spinal group (p < 0.025), and 361 +/- 51 min at the L2 level, versus 210 < 44 min in the other group (p < 0.025). "Topping up" was possible with the epidural catheter only, thus raising the level of sensory blockade, making it deeper, and increasing its duration. It avoids the use of general anaesthesia in case of failed spinal blockade.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1992

[Severe iatrogenic hyponatremia in a pregnant woman].

Severe hyponatremia may be associated with several complications leading sometimes to the death of the patient. We present the case of a healthy young pregnant woman who developed a severe acute iatrogenic hyponatremia (120 mEq.l-1). The treatment of the acute dehydration due to hyperemesis gravidarum led to a dilutional hyponatremia. The causes, complications and management of severe acute hyponatremia are discussed.

Acute Disease↗
PubMed1991

[Problems raised by the administration of a peridural block in patients receiving anticoagulant therapy].

More and more patients likely to get an epidural block are treated with anticoagulant or antiplatelet drugs. An epidural hematoma may be consecutive to an injury of the epidural venous plexus. The mechanisms of action of the different drugs are reviewed. The bleeding time is not an infallible indication of aspirin or other non steroidal antiinflammatory drugs platelet defect. The protocol used in our institution for the administration of an epidural block in this group of patients is discussed.

Anesthesia, Epidural↗
PubMed1991

[The use of 0.5% bupivacaine by infiltration for analgesia during thyroidectomies].

We studied the postoperative analgesia in 25 patients scheduled for a thyroidectomy or a parathyroidectomy. In 15 patients we used wound infiltration of bupivacaine 0.5%. In both groups we compared the pain score and the analgesic drugs administered after the surgery, within the first 24 hours. We found that wound infiltration is a very efficient way to prevent and to treat the postoperative pain.

Adolescent↗
PubMed1990

[Computerized electroencephalographic monitoring in anesthesia].

The computerized electroencephalogram monitor provides a simple interpretation of the standard EEG trend. In the operating room, this compact EEG monitor is convenient and the trend is easy to read for a non-specialist user. EEG monitoring is especially indicated in carotid endarterectomy for the detection of ischemic event during surgery. The use of this monitor should be recommended for high risk patients (cardiac surgery, cerebral aneurysm surgery, controlled hypotension) to determine the adequate depth of anesthesia and to perform a stress-free anesthesia when the anesthetic drug is given by titration according to the decrease in the awakening electrical cerebral activity.

Anesthesiology↗
PubMedDate not supplied

Combined general and epidural anesthesia for a patient with Takayasu's arteritis. Case report.

BACKGROUND AND OBJECTIVES: The case is presented of a 44-year-old woman with type I Takayasu's arteritis, undergoing total abdominal hysterectomy. METHODS: Her previous symptoms were related to subclavian and vertebral artery lesions that were treated surgically, and to right carotid stenosis (amaurosis fugax 1-year before the operation) that was not treated. Peripheral pulses were present and blood pressure monitoring was not a problem (invasive intra-arterial pressure monitoring was used). Neurologic monitoring was considered to be mandatory in this case and a computerized electroencephalography monitor was used, both to confirm the adequacy of anesthesia and, more importantly, to monitor unilateral cerebrovascular events. RESULTS: The patient underwent surgery with combined epidural and general anesthesia, without any complications. The epidural block was used throughout the early postoperative period for analgesia. CONCLUSIONS: The management of patients with Takayasu's arteritis requires a knowledge of the location and pathophysiology of vascular lesions.

Adult↗
PubMedDate not supplied

Removal of knotted epidural catheters.

BACKGROUND AND OBJECTIVES: An epidural anesthetic was planned for a 24-year-old woman for analgesia during labor and for a 28-year-old woman for an elective cesarean delivery. METHODS: Two cases of inability to remove an epidural catheter due to a knot are reported. The epidural catheter was initially inserted 6 and 8 cm, respectively, into the epidural space. Attempts to remove the catheter by gentle traction remained unsuccessful. RESULTS: In the first case, the catheter was removed successfully by using general anesthesia with succinylcholine, and in the second case the catheter was removed by pulling it out slowly. CONCLUSIONS: To prevent the knotting of an epidural catheter, it should not be inserted more than 3-4 cm into the epidural space. General anesthesia may be one of the options to remove the catheter.

Adult↗