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J Carcey

Publications and source records attributed to J Carcey.

4 recordsLinked to original sources

[Functional surgery for movement disorders: implications for anaesthesia].

Functional surgery for movement disorders is a recent stereotactic neurosurgical operation, restricted yet to patients with advanced Parkinson's disease or with generalized primary dystonia. One or two electrodes are implanted in the basal ganglia, namely in the globus pallidus pars interna or in the subthalamic nucleus, to realize a deep brain stimulation at high frequency. While this approach needs additional data to demonstrate clinical benefits, first results observed after short and long-term follow up are encouraging. Perioperative problems in patients with Parkinson's disease are possible respiratory disorders, a postoperative miss in medication doses and potential drug interactions with anaesthesia. The objectives of anaesthesia will be to allow stereotactic neurosurgical procedure, to maintain the upper airway patency and to be quickly reversible.

Anesthesia↗

[Effect of nicardipine on cerebral vasomotor activity in hypocapnia].

Nicardipine, a calcium channel antagonist derivative of dihydropyridine, is a cerebral vasodilatator used in the treatment of cerebral vasospasms induced by subarachnoid hemorrhage after rupture of intracranial aneurysm. Hypocapnia is a powerful vasoconstrictor of cerebral arteries, and antagonizes in the baboon the cerebral vasodilative effect of nimodipine, another derivative of dihydropyridine. The action of nicardipine in presence of hypocapnia was not yet study in human. The study of the interaction of nicardipine and hypocapnia on the cerebral arteries show that hypocapnia antagonizes the cerebral vasodilatator properties of nicardipine.

Adult↗

[Blood loss and nausea during legal abortion].

The efficiency of oxytocic drugs in therapeutic abortion was studied in 113 women who were randomly assigned to either a control group (n = 44) receiving no oxytocic drugs, a group (n = 36) receiving 0.2 mg ergometrine by slow intravenous injection, or a group (n = 33) given 5 units oxytocin in a intravenous infusion throughout the procedure. The three groups were comparable with regard to the age of patients, the age of pregnancies and parity. The surgical procedure was the same in all three groups and carried out by the same surgeon. General anaesthesia was obtained with an infusion of 500 mg methohexitone and 500 micrograms fentanyl in 500 ml isotonic dextrose solution at a rate of 3 ml X min-1. The anaesthetic requirements were 2.94 +/- 0.80 micrograms X kg-1 fentanyl and 2.94 +/- 0,80 mg X kg-1 methohexitone. The criteria studied were the blood loss as measured by the volume aspired, the presence or absence of nausea and vomiting after the procedure, the age of pregnancy and the total amount of anaesthetic drugs given. No correlation was found between the amount of anaesthetic drugs given and the frequency of nausea and vomiting, and between the amount of blood lost (r = 0.287; ddl = 111; alpha = 17.322). The study did not, therefore, confirm the reputation of oxytocic drugs in reducing the bleeding. It seemed that, in therapeutic abortion, spontaneous uterine contraction was sufficient to control the bleeding. But a significant correlation was found between the amount of blood lost and the age of the pregnancy (r = 0.399; ddl = 111; alpha less than 1%).

Abortion, Legal↗