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F Bolandard

Publications and source records attributed to F Bolandard.

11 recordsLinked to original sources
PubMed2006

[Perineal regional anaesthesia: indications in gynaecologic and proctologic surgery and in obstetric].

Perineal and proctologic surgery is well known as very painful. The apparition of new specific needles, long acting and less toxic local anaesthetics and neurostimulation allowed reconsidering some old forgotten techniques. Those blocks appear really useful to optimize multimodal postoperative analgesia and postoperative rehabilitation. After anatomic review, authors describe perineal regional anaesthesia and discuss about main indications and advantages, in the eyes of their experience and bibliographic review.

Anesthesia, Conduction↗
PubMed2006

[Fertiloscopy: Clermont-Ferrand's experiment].

OBJECTIVE: Evaluation of fertiloscopy's place in the management of female infertility. PATIENTS AND METHODS: Retrospective study including 229 women presenting primary or secondary infertility without pathology raising of an evident surgical sanction and benefitting from a fertiloscopy. Perioperative data analysis (context of the infertility, operating technique, complications). RESULTS: Two hundred and three fertiloscopic procedures succeeded (88.6%), revealing lesions in 58 cases (28.6%) requiring a laparoscopy. These are represented by adherences (21 cases), endometriosis (17 cases), an abnormality of the tubal permeability (10 cases), complete or partial failure to visualize the adnexae (6 cases) and ovarian cysts visualization (4 cases). Five complications (2.5%) without major consequence will be deplored: two rectal injuries, two hemorrhagic complications and a postoperative salpingitis. Most of procedures (97.5%) have been performed in an ambulatory setting except when a geographic remoteness did not allow it (5 patients). DISCUSSION AND CONCLUSION: Fertiloscopy is a safe and reliable procedure. It can be substituted to laparoscopy in the routine assessment of infertile women management in case of not obvious surgical indication.

Adolescent↗
PubMed2006

[Pelvic pain by acute symphysis pubis separation after vaginal delivery].

Pelvic pain during pregnancy and postpartum period is common. Pubic separation is a physiologic phenomenon caused by pregnancy and delivery. It's an aetiology of pregnancy and postpartum pain requiring a specialized management in case of severe pain. We report the case of a 34-year-old multiparous woman suffering from severe pubic symphysis pain after twin delivery by vaginal approach, with extraction support, under epidural analgesia. Pubic symphysis separation was diagnosed according both to the clinical symptoms and to the radiology. A local anesthetic infiltration was performed twice to substantially relieve the patient.

Adult↗
PubMed2006

[Laparoscopic management of ovarian cysts during pregnancy].

OBJECTIVE: To evaluate the results of laparoscopic surgery in the management of ovarian cysts in pregnant patients. PATIENTS AND METHODS: Retrospective study including 26 pregnant patients who underwent the laparoscopic management of ovarian cysts. The indications for surgery were persistent adnexal mass, abnormal ovarian cysts revealed by ultrasound examination, suspicion of cyst complications. The technique used, the immediate postoperative results and obstetrical outcomes were studied. RESULTS: Twelve patients were operated during the first trimester of pregnancy, 13 in the second, and one in the third trimester. A 12 mmHg CO2 pneumoperitoneum was created, using a Veress needle in 22 cases, and an open technique in 4 cases. Trocar sites were decided according to the uterine size and to the cyst situation. A cystectomy was performed in 11 cases, an adnexectomy in 7 cases, an oophorectomy in one case, a cyst aspiration with a biopsy of the cyst wall in 6 cases and an ovarian torsion removal in one case. A conversion to laparotomy was necessary in 3 cases. There were no immediate postoperative complications and obstetrical outcomes were good in all cases. DISCUSSION AND CONCLUSION: In pregnant patients, laparoscopic management of adnexal masses appears to be safe for both mother and child.

Adult↗
PubMed2005

[Pregnant woman anaesthetic management in gynaecologic laparoscopic surgery at the maternity hospital of Clermont-Ferrand].

OBJECTIVE: To evaluate the anaesthetic management intended for pregnant women in the field of non obstetric and gynaecologic laparoscopic surgery. STUDY DESIGN: Retrospective and monocentric investigation. PATIENTS AND METHODS: Analysis of the anaesthetic and obstetric files from 27 pregnant women operated on in the establishment, between January 2001 and July 2004. RESULTS: 27 female patients involved in the study. The mean pregnancy term was 15 weeks when laparoscopic surgery was performed, though a single patient was at 30 weeks. The average duration of the surgery was 61 minutes, of which 28 minutes were dedicated to pneumoperitoneum. Twenty-four patients underwent general anaesthesia, the three others underwent locoregional anaesthesia. During the perioperative period no surgical, anaesthetic or obstetric complications were observed. CONCLUSION: Laparoscopic surgery during pregnancy requires double skilled management, both in anaesthesiology and obstetrics. On haemodynamics and breathing, pneumoperitoneum does not induce any additional effects when compared to operations without pregnancy. Except with delivery cases, anaesthetic support in laparoscopic surgery intended for pregnant women eventually does not generate any specific problems, but requires the same rigorous management as the one usually following surgery for pregnant patients.

Adult↗
PubMed2005

[About three consecutive pregnancies in a patient suffering from liver cirrhosis].

We report the case of a patient suffering from an immune liver cirrhosis with chronic liver insufficiency and a portal hypertension, presenting with three consecutive pregnancies. During the first pregnancy, stillbirth occurred at 34 weeks gestation (WG) with a justified vaginal delivery. There was no liver deterioration during the second pregnancy until 36 WG when fetal distress occurred, requiring a caesarean section under general anaesthesia. During the third pregnancy, fetal distress and maternal hepatic failure occurred at 35 WG, requiring an emergency caesarean section complicated with post partum haemorrhage and an episode of encephalopathy.

Adult↗
PubMed2004

[Prolonged motor blockade after combined epidural and general anaesthesia for oncologic gynaecological surgery].

The case described is a patient submitted to an oncologic gynaecological surgery under combined epidural and general anaesthesia. The anaesthesia involved complications, a prolonged motor blockade for up to 9 h whereas recommended doses had been respected. A few later after a magnetic resonance imaging that did not showed any extradural haematoma, full recovery occurred. The combined epidural and general anaesthesia was approved as an interesting technique for both per and postoperative analgesia, but also for postoperative rehabilitation. Nevertheless, for older patients, inhalational anaesthetics and opioids have to be decreased during the intervention, moreover local anaesthetics doses for epidural anaesthesia have to be reduced too, in order to control motor blockade duration.

Anesthesia, Epidural↗
PubMed2003

Epidural versus intrathecal morphine for postoperative analgesia after Caesarean section.

BACKGROUND: Perispinal anaesthesia for Caesarean section allows injection of epidural (ED) or intrathecal (i.t.) morphine to provide long-lasting postoperative analgesia. To compare these two routes, a prospective, randomized, double-blinded study of 53 patients undergoing elective Caesarean section was performed. METHODS: Combined spinal-epidural anaesthesia with 6 mg of i.t. hyperbaric bupivacaine plus sufentanil 5 microg, and additional ED lidocaine was used. Additionally, each patient received either 2 mg (2 ml) of ED morphine plus 1 ml of i.t. normal saline (ED group, n=28), or 0.075 mg (1 ml) of i.t. morphine plus 2 ml of ED normal saline (i.t. group, n=25). Additional postoperative analgesia was given in the form of propacetamol and ketoprofen, plus self-administered i.v. morphine. RESULTS: No major respiratory depression occurred. Time to first demand of morphine was similar in the ED (307.5 min) and i.t. (310 min) groups, as was the incidence of side-effects such as sedation, pruritus, nausea, and vomiting. During the first 24 postoperative hours, VAS pain scores were greater in the i.t. group (P=0.032), as was additional morphine consumption (4 vs 1.5 mg) (P=0.03). CONCLUSIONS: The ED protocol was more effective than the i.t. protocol, whilst side-effects were similar.

Adult↗
PubMed2001

[Physiopathologic consequences of laparoscopic surgery].

The aim of this present review was to study the effects of the intraperitoneal carbon dioxide insufflation, on the different physiological functions in order to prevent or to treat the side effects or complications which may occur in laparoscopic surgery. The major data from literature are confronted with the practical knowledge from a group of anesthetists with large experience in gynecological laparoscopic surgery.

Anesthesia, General↗
PubMed1995

[Plasma exchange and severe Plasmodium falciparum malaria. Apropos of 2 cases].

Severe Falciparum malaria is associated with multiple organ dysfunction and a high rate of fatal outcome. Appropriate antimalarial chemotherapy and symptomatic treatment may be supplemented by early plasma exchange. Two cases are reported in which there were no chemoprophylaxis and a late diagnosis. Initial parasitaemias were 17% and 5%. The two patients had cerebral malaria with in the first case pulmonary oedema and DIC. Plasma exchange was performed and clinical biological symptoms abated quickly. The mechanisms of action and benefits of plasma exchange are discussed.

Adolescent↗