Biomedical subjects

D Peillon

Publications and source records attributed to D Peillon.

4 recordsLinked to original sources

PubMed1996

[Do corticotherapy and hemodilution decrease postoperative inflammation after maxillofacial surgery?].

OBJECTIVE: To assess the efficiency of corticosteroids and preoperative acute normovolaemic haemodilution (PANHD) in reducing postoperative inflammation after maxillofacial surgery. STUDY DESIGN: Randomized clinical trial. PATIENTS: Thirty-two patients scheduled to undergo maxillary osteotomy for facial dysmorphia were randomized into four groups of eight (PANHD or not; corticosteroids or not). METHODS: PANHD decreased haematocrit to 30%. In the corticosteroid groups, methylprednisolone 1.5 mg.kg-1 was given intravenously at the beginning of surgery (after PANHD in haemodiluted group), and after surgery, 1.5 mg.kg-1 iv daily for three days. Postoperative inflammation was assessed with an X-Ray technique (radiotelemetry) providing data on tissue thickness (extent of facial oedema), and by measurement of plasma concentrations of four acute phase proteins during the first postoperative week. RESULTS: No change in facial oedema and in acute phase proteins occurred with PANHD. Corticosteroids decreased postoperative oedema and acute phase proteins. CONCLUSION: Corticosteroids decrease postoperative inflammation after maxillofacial surgery but not PANHD.

Acute-Phase Proteins↗

PubMed1995

Acute normovolaemic haemodilution does not reduce the inflammatory process induced by facial surgery.

The place of preoperative acute normovolaemic haemodilution (haematocrit = 28%-32%) in reducing postoperative inflammation was evaluated after facial surgery. Thirty-two patients scheduled for mandibular osteotomy were randomized to a nonhaemodiluted group or to a haemodiluted group. The degree of postoperative inflammation was evaluated: first by an x-ray technique (radiotelemetry) providing measurements of the tissue thickness (quantitation of facial oedema), and second by the measurement of four acute phase protein plasma concentrations during the first postoperative week. Throughout the study, no changes in facial oedema or in variation of acute phase proteins were detected after haemodilution. It is concluded that acute normovolaemic haemodilution has no effect on the intensity of facial oedema and the biological inflammation process after facial surgery.

Acute-Phase Proteins↗

PubMed1995

[Cerebrovascular reactivity to CO2 during general anesthesia maintained with either isoflurane-N2O or propofol-N2O. A comparative study by transcranial Doppler velocimetry].

OBJECTIVES: To compare, using transcranial doppler velocimetry (TDV), the cerebral blood flow velocity and CO2 reactivity during general anaesthesia maintained with either isoflurane-N2O-O2(IF) or propofol-N2O-O2 (PF) in adults with a normal brain. STUDY DESIGN: Nonrandomized controlled trial. PATIENTS: Forty ASA I patients (mean age 41 +/- 13 yrs, 15 F/35 M) undergoing surgery of the lumbar spine in prone position. The first 20 were allocated into the IF group and the subsequent 20 into the PF group. METHODS: General anaesthesia was induced with midazolam (0.05 mg.kg-1), phenoperidine (0.03 mg.kg-1), thiopentone (5 mg.kg-1), vecuronium (0.1 mg.kg-1) and maintained with N2O (50 vol %) and O2 (50 vol %) and either isoflurane (0.8 < Fet < 1 vol %) in IF group or propofol (6 mg.kg-1.h-1) in PF group. The vascular reactivity was assessed with velocimetry measurements (Angiodine DMS, with a probe transmitting a 2-MHz pulsed wave) of flow in the middle cerebral artery at a given PetCO2 (obtained by adjustments of VT) during systole (SV) and diastole (DV). Three measurements were made: at T1 (PetCO2 = 30 +/- 2 mmHg), at T2 (PetCO2 = 40 +/- 2) and at T3 (PetCO2 = 30 +/- 2 mmHg). RESULTS: In the IF group, VS increased by +32% at T2 (P = 0.006) with an increase of + 3.4 %/1 mmHg of PetCO2. Similarly, in the PF group VS increased by + 31 % at T2 (P < 0.0001) with an increase of 2.9 %/1 mmHg of PetCO2. In both groups the VS returned to baseline values at T3. In the IF group, VD increased by + 66% at T2 (P < 0.0001), with an increase of + 7%/1 mmHg of PetCO2. Similarly in the PF group, VD increased by + 61% (P < 0.0001) with an increase of + 5.7%/1 mmHg of PetCO2. In both groups the VD returned to baseline values at T3. CONCLUSIONS: During anaesthesia maintained with either isoflurane-N2O-O2 or propofol-N2O-O2, a change in PetCO2 results in similar changes in VS and VD. These anaesthetic agents preserve the cerebrovascular reactivity of the normal brain. The results of this study are in accordance with those obtained with other reference techniques in healthy volunteers. Transcranial doppler velocimetry can be a useful noninvasive tool of clinical research in neuroanaesthesia.

Adult↗

PubMed1994

[Indications of planned sedation following intracranial neurosurgery. Prospective study of decisional criteria].

General Anaesthesia (GA) is usually stopped early after intracranial surgery. An impaired neurological status or surgical difficulties may lead to sedate some patients (pts) in the intensive care unit (ICU). The aims of the study were to establish and to evaluate predictive criteria for post- operative sedation. In one group (G1), GA and mechanical ventilation (MV) were discontinued early after surgery and pts stayed at least 12 h. in the ICU. In the other group (G2), sedation and MV were prolonged 24 h., until a clinical and scannographic evaluation. Thereafter, sedation was discontinued or prolonged according to both surgical and anesthetic considerations. These criteria were established according to the literature and to local practices. Before surgery, they depended on clinical status, radiological data and etiology; during surgery, on surgical and medical semiology and difficulties or incidents during the procedure. Adult pts undergoing intracranial surgery under GA were consecutively included in a 6 months prospective study. Patients suffering acute head trauma, pre operative coma (Glasgow CS < 8) or extraneurologic disease (responsible for delayed MV weaning) were not included. Sedation was performed with midazolamR (.05-.15 mg.kg-1.h-1) + phenoperidineR without myorelaxation. The ideal level of sedation was established as defined by Boeke. One hundred and ninety five pts (80 f; 49 +/- 15y-o) were included (G1 = 130, G2 = 65). Surgical indications were: malignant tumor = 61, meningioma = 50, vascular disease = 53, other = 31. ICU stay lasted 5.6 +/- 8 d and MV 3.7 +/- 7 d.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗