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Biomedical subjects

A Landais

Publications and source records attributed to A Landais.

18 recordsLinked to original sources
PubMed1992

[The computerized anesthesia record].

The first anaesthetic record was introduced into medical practice in 1940. Since then few changes have been made to it and it remains a rudimentary memorandum. However, since the beginning of the 1980s, interest in automatic recording of the anaesthetic file has been increasing and numerous arguments can be put forward in its favour. Apart from theoretical and experimental arguments, in practice one has to master the automatic collection of data, management of alarms and the technology of the networks involved in order to manage the flow of information by channelling it and organizing it into a hierarchy. Four other objectives can be added to the clinical recording and its medico-legal applications: anaesthetic cost evaluation, quality of care, research and clinical teaching which will provide the basis of anaesthetic epidemiological research.

Anesthesiology↗
PubMed1991

[Pollution of operating rooms. Measurements made during five anesthesias].

The purpose of this study is to measure amounts of anaesthetic vapours present in operating rooms and anaesthetic places without any gas scavenging system except air conditioning with fifteen air changes per hour. Nitrous oxide, halothane and isoflurane were measured. Halothane and isoflurane concentration is slightly higher than the French standard for anaesthetic places and lower for operating rooms. Nitrous oxide concentration is five to eight times greater than recommended standard. Although no international agreement exists concerning an acceptable pollution standard, it seems that only nitrous oxide pollution is disquieting. It would seem sensible to avoid needles contamination by use of waste gas scavenging devices.

Abdomen↗
PubMed1990

Measurement of cardiac output by the thermodilution method during left thoracotomy in the lateral position in the dog.

The validity of cardiac output measurement by thermodilution in the lateral position during thoracotomy was assessed. Three balloon thermodilution Swan-Ganz catheters were placed in the pulmonary artery trunk and the right and left pulmonary arteries in 12 mongrel dogs, after left thoracotomy had been performed. Cardiac output was measured simultaneously from two of the three sites. The cardiac output measurements show no significant difference related to the location of the catheter extremities: the mean cardiac index was found to be 2.164 +/- 0.448 l/min/m2 from the pulmonary artery trunk, 2.127 +/- 0.404 l/min/m2 from the left branch and 2.116 +/- 0.421 l/min/m2 from the right branch. It is concluded that the measurement of cardiac output during left thoracotomy is valid, whether the thermistor is situated in the pulmonary artery trunk or in a main branch to either the dependent or non-dependent lung.

Animals↗
PubMed1990

The use of midazolam in diagnostic and short surgical procedures in children.

A new technique of sedation for children is described, in which midazolam (0.2 mg.kg-1) was administered topically by the nasal route, followed by ketamine (9.0 mg.kg-1) administered rectally in 32 patients breathing air spontaneously. Sedation was good in 23, seven required further ketamine (1.0 mg.kg-1 i.v.), and in two, halothane was introduced. There was no evidence of severe respiratory depression except during oesophagoscopy. Cardiovascular stability was excellent. Of 21 patients over 5 years old, 19 developed complete and two partial anterograde amnesia for the administration of ketamine and surgery. The major complications were nausea and vomiting (five patients) and salivation (eight patients). The mean recovery time was 40 min (s.d. 33 min). It provided a relatively safe, adaptable, non-invasive method of inducing sedation in children.

Administration, Intranasal↗
PubMed1988

Prevention of postoperative venous thrombosis: a randomized trial comparing unfractionated heparin with low molecular weight heparin in patients undergoing total hip replacement.

A double blind randomized trial comparing subcutaneous enoxaparin (40 mg once daily) with standard unfractionated calcium heparin administered at a dose of 5,000 units every 8 hours in patients undergoing elective hip replacement has been performed. Treatment regimens began 12 hours preoperatively with enoxaparin, 2 hours preoperatively with standard unfractionated calcium heparin, and were continued for 15 days or until discharge. Venography was performed in all patients. Two hundred thirty-seven patients were included in the study: 113 received unfractionated heparin and 124 received enoxaparin. The incidence of proximal deep vein thrombosis was reduced from 18.5% in the unfractionated heparin group to 7.5% in the enoxaparin group (p = 0.014), and the incidence of total deep vein thrombosis was similarly reduced from 25% to 12.5% (p = 0.03). There were two major bleeding episodes and one minor bleed in the enoxaparin group compared to two minor bleeds in the unfractionated heparin group. Patients who received enoxaparin required fewer red blood cell transfusions and had a significantly higher hemoglobin on postoperative days 3 and 4. Thus prophylaxis with enoxaparin, 40 mg once daily, is simple, safe and more effective than standard low dose unfractionated heparin in preventing deep vein thrombosis in patients undergoing elective hip replacement.

Aged↗
PubMed1987

[Pharmacokinetics of propofol as an induction agents in adults].

The disposition kinetics of Propofol have been determined in 7 patients (3 men, 4 women) receiving 2.5 mg/kg for induction of anaesthesia. Peripheral venous samples were collected up to 12 hours after injection of the drug. Data analysis indicates a 3 compartment model with a terminal half-life of 480 +/- 141 min, clearance of 0.0352 +/- 0.0014 l/min/kg and volume of distribution of 24.2 +/- 6.2 l/kg.

Anesthetics↗
PubMedDate not supplied

[Double-blind randomized comparative study of enoxaparin and standard heparin in the prevention of thromboembolic disease during insertion of total hip replacement].

237 patients with a non-traumatic disease of the hip requiring total hip replacement entered a multicentre trial. Treatments were allocated at random in a double-blind manner: 113 patients received 5000 IU of standard heparin t.d.s.; 124 patients received enoxaparin 40 mg once a day. Treatment lasted from 10 to 15 days until bilateral ascending phlebography of the lower limbs (BAPLL) was performed. Its effectiveness was assessed by the results of BAPLL, by evaluation of the risk of bleeding on examination of the surgical wound, by the units of blood required for perfusion and by daily blood count and differential. BAPLL was performed in 228 patients: 15 phlebographies (12.5 p. 100) were positive in the 120 assessed patients of the enoxaparin group, while 27 (25 p. 100) were positive in the 108 assessed patients of the standard heparin group (p = 0.014). Proximal deep vein thrombosis was significantly (p = 0.03) less frequent in the enoxaparin group (7.5 p. 100) than in the standard heparin group (18.5 p. 100). Pulmonary embolism was observed in a patient on standard heparin. The units of blood required for perfusion were significantly (p = 0.03) smaller in the enoxaparin group (3.37 +/- 1.81 U) than in the standard heparin group (3.84 +/- 1.70 U). Thus, one single subcutaneous injection of enoxaparin 40 mg daily was significantly more effective and safer than standard heparin 5000 IU t.d.s. in the prevention of deep vein thrombosis after total hip replacement.

Aged↗
PubMedDate not supplied

[Addition of fentanyl to adrenalinized lidocaine for the brachial plexus block].

This study was designed to investigate the effects of fentanyl associated with lidocaïne in a solution used to perform axillary brachial plexus nerve block. Adrenergic, sensory and motor nerve blocks have been studied separately and compared to a control group receiving lidocaine without fentanyl. For each type of fibre, the degree of block was measured on, 2, 3, 4, 5 and 10 minutes after injection and the result were studied by variance analysis. Axillary nerve blocks were performed in two different hospitals by two anesthesiologists. After giving informed consent, the patients were randomly allocated in two groups receiving 30 ml 1.5% lidocaine with 1/200,000 epinephrine, with or without fentanyl 100 mu. There were no statistical differences between the two groups as far as adrenergic nerve block was concerned, whereas sensory and motor nerve blocks were significantly more important as soon as five minutes after injection and lasted longer when fentanyl was added to the solution. This enhancement of intensity and duration of sensory and motor nerve blocks when fentanyl is added allows a reduction of the quantity of lidocaine required, and shortens the delay between injection and complete blockade.

Adult↗