PubMed Health⌕ Search

Biomedical subjects

J Du Cailar

Publications and source records attributed to J Du Cailar.

At least 19 recordsLinked to original sources
PubMed1984

[Intramuscular premedication with midazolam in infants and children].

The useful intramuscular premedication dose of midazolam was determined in 100 children divided up in three age groups: one month to three years, 3 to 10 years, 10 to 15 years. All biometric parameters were normal for the age, and comparable between similar age groups. Haemodynamic and respiratory parameters were not altered by the premedication. The reduction in anxiety, as assessed by the child's behaviour, was good or excellent in more than 85% of cases from all age groups; it was proportional to the dose used. The doses that had, for equivalent reductions in anxiety as assessed by the chi-square test, the least hypnotic effect, were: 0.5 mg X kg-1 before three years of age, 0.4 mg X kg-1 for the 3 to 10 yr olds, and 0.25 mg X kg-1 for the 10 to 15 yr olds. This fall in dose with age, quite usual in paediatrics, was not unexpected. The level of consciousness, one hour after surgery, was always normal. No undesirable side-effect was observed. These results, together with its physical, chemical and pharmacodynamic characteristics, make midazolam a choice drug for intramuscular premedication in children, with a foreseeable use in day-care anaesthesia. The unexpected finding of an age-dependent dissociation between the reduction in anxiety and the hypnotic effect is discussed in the light of a study carried out in the adult and recent data from the literature.

Adolescent↗
PubMed1983

Hypnotic efficacy of midazolam in pre-surgical patients: a dose-finding study.

The hypnotic effect of midazolam on the sleep of pre-surgical patients was studied in 99 patients (53 males, 46 females) due to undergo surgery the following day. One tablet of 15 mg midazolam was administered at 21.00 h and a second was given 45 min later if the subject had not fallen asleep, sleep-onset latency being measured from the time the second tablet was taken. Eighty patients required 1 tablet and 19 required 2 tablets. According to the subjective assessment, patients receiving 1 tablet fell asleep in 22.9 +/- 14.9 min and those taking 2 tablets fell asleep in 38.4 +/- 25.3 min (difference significant P less than 0.05). There was no statistically significant difference between the 1- and 2-tablet groups with regard to sleep duration, number of awakenings, overall assessment of the night's sleep, sleep quality and state on awakening. Factors which had a statistically significant influence on the dosage requirement were (a) sex, 30.4% females requiring a second tablet v. 9.4% males; (b) age, the mean age of the 2-tablet group being 36.5 v. 47 years in the lower dose group; (c) weight, patients with lower body weight requiring the higher dosage, mean 57.5 v. 66 kg; (d) current insomnia or a history of sleeping problems; (e) previous use of hypnotics; (f) degree of insomnia, moderate/severe insomnia needing a higher dosage (42% v. 21%).(ABSTRACT TRUNCATED AT 250 WORDS)

Anti-Anxiety Agents↗
PubMed1982

[Evaluation of vital prognosis in gas gangrene by a method of multivariate analysis of the results of the initial clinical examination].

Prognosis value of initial clinical symptoms and findings in gas gangrene was evaluated in 72 patients. Fifty eight parameters were recorded. The relationship between the simultaneous effects of several variables upon survival was accomplished using the multivariate technique, discriminant analysis. On the basis of observed patients deaths or survivals, the individual condition weights were statistically derived in a manner that best distinguishes likely survivors from nonsurvivors. Six variables out of the 58 studied gave right classification of outcomes in 97 p. 100 of the patients.

Adolescent↗
PubMed1982

[Maternal and fetal levels of local anaesthetics after epidural injection of a triple mixture].

Twenty-four parturients received an epidural injection of a 5.10(-6) adrenaline mixture containing: lidocaine 295 +/- 19 mg, bupivacaine 58 +/- 4 mg and etidocaine 58 +/- 4 mg. The mean serum levels measured in the mother (peripheral vein) and in the fetus (umbilical vein) and in the fetus (umbilical vein) and the fetus/mother ratios were, respectively:--1.05 +/- 0.47 micrograms . ml-1, 0.68 +/- 0.34 micrograms . ml-1 and 0.66 +/- 0.15 for lidocaine; --0.25 +/- 0.10 micrograms . ml-1, 0.14 +/- 0.06 micrograms . ml- and 0.51 +/- 0.16 for bupivacaine; ---0.27 +/- 0.10 micrograms . ml-1, 0.17 +/- 0.10 micrograms . ml-1 and 0.63 +/- 0.23 for etidocaine. From the sum of these concentrations the maternal and fetal serum levels and the fetus/mother ratio could be calculated in lidocaine equivalents. The values obtained were: 3.14 +/- 0.74 . ml-1, 1.90 +/- 0.68 micrograms . ml-1 and 0.60 +/- 0.13 respectively. A comparison of these data with those found in the literature led to the following conclusions: (1) The maternal serum levels of each anaesthetic drug in the mixture are the same as if it had been injected separately; (2) owing to tissue competition, the transplacental passage is increased by majoration of the free form, this being more pronounced with bupivacaine and etidocaine; (3) the circulating drug concentrations evaluated as lidocaine equivalent in the mother and fetus are comparable to those determined at the end of conventional local anaesthetic procedures.

Anesthesia, Epidural↗
PubMed1976

[In tolerance reactions to Rheomacrodes. Apropos of 3 cases].

Three cases of reactions of intolerance to Rheomacrodex were observed during these last four years in our Department, and this led us to attempt to sum up their exact nature and in particular the possibility of an immuno-allergic orgin. From the clinical standpoint, the symptomatology is dominated by the combination of abrupt collapse associated with Quincke's edema in two cases, and with bronchospasm in the third. The course was rapidly favourable under respiratory and circulatory emergency resuscitation. The immuno-allergic enquiry carried out in one case, did not enable one to demonstrate the responsibility of an antigen-antibody reaction. Analysis of the different works appeared on this subject, in particular those of the Swedish school, of W. RICHTER et col., did not enable one to pick out with any certainty the responsibility of an antigen-antibody conflict in the genesis of these reactions.

Adult↗
PubMed1975

[Comparison of the endocrine response under 2 kinds of anesthesia: neuroleptanalgesia of the chlorprothixene-dextromoramide type and venous anesthesia of the type alfadione-fentanyl].

In 14 patients anaesthetized before undergoing an orthopedic surgical intervention, the variations induced by anaesthesia in the 17 hydroxycorticosterone rate, catecholamine, somatotropic hormone (STH), insulin, glycemia, free fatty acids and thyrotropin (TSH), all these variations were studied before the surgery. The patients were divided into 2 groups of 7, the first one being anaesthestized by chlorprothixene dextromoramide Neurolept-Analgesia and the second one by Alfadione Fentanyl venous anaesthesia.

Alfaxalone Alfadolone Mixture↗
PubMed1975

[The setting up of a computer system for records of first entries at the emergency medical assistance service in Montpellier].

The setting up of a computing device to exploit the files of first transports at the MONTPELLIER SAMU was started essentially in order to constitute a document both accurate and of easy access, able to memorize the physical and mental behaviour of a patient in a transient state. The results thus obtained include: 1 -- An analytical study with a part devoted to general data such as the number of injured people or of patients, the number of calls from various sources, the means of intervention etc. and a more specific part dealing with type of accident the determination of the traumatic impacts, the first therapy etc.; 2 -- A synthetical study that constitutes the second phase of the dealing with information thanks to the drawing up of graphs indicating the number of calls per accident according to the time, the age, the number of serious cases etc.

Computers↗
PubMed1975

[High altitude acute pulmonary edema (author's transl)].

HAAPE has been recognised only recently but is of real interest as much from the clinical as well as the dogmatic stand-point owing to the complexity of its physiopathological findings. It is encountered at altitudes higher than 4,000 meters either during a first contact or in natives returning from low altitude zones. There is an individual or even racial susceptibility.

Altitude↗
PubMed1975

[Justification, methods and indications for positive-pressure respiration in controlled and spontaneous ventilation in lesional pulmonary edeman].

Proposed since 1938 as a treatment for pulmonary edema, continuous positive pressure ventilation (PPP) still called teleexpiratory positive pressure in France (PPTE) and "Positive End Expiratory Pressure" (PEEP) or even "Continuous Pressure Breathing" (CPPB) in Anglo-Saxon countries, has taken a place in the first line of therapy in refractory hypoxia and particulary when the latter originate from lesional pulmonary edema. The aim of PPP is to open up the alveolar territories by calling on their elastic properties, to fight against micro-atelectasis and bronchial collapse, to diminish the closing volume, to increase the FRC, thereby improve VA/Qc, decrease Qs/Qt and increase PaO2. Furthermore, in the particular case of pulmonary edema, PPP acts against the hydrostatic pressure by increasing the external component of the transmural pressure and by evening out pulmonary capillary blood flow.

Carbon Dioxide↗