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Biomedical subjects

J-C Sleth

Publications and source records attributed to J-C Sleth.

6 recordsLinked to original sources
PubMed2006

[Paracervical block in obstetrics].

OBJECTIVE: To review the most recent and relevant issues concerning paracervical block in obstetrics since 1975 when Jägerhorn described the superficial technique that has become a standard. DATA SOURCES: Extraction from Pubmed database of articles issued from 1975 to 2005. DATA SELECTION: The collected articles were selected on the basis of the use of the superficial injection method. The more recent data were selected. The keywords were: paracervical, labour, childbirth, and neonate. DATA SYNTHESIS: Paracervical block (PCB) is routinely used over the world despite the risk of foetal bradycardia. Bradycardia occurring immediately after the performance of block is short lasting. The reports of few cases of foetal or neonatal deaths have caused many physicians to question its safety. The incidence of bradycardia has dramatically decreased (less than 10%) due to the Jägerhorn superficial injection method. In case of healthy neonate the occurrence of bradycardia is harmless but its mechanism is still imprecise. The intensity an duration of analgesia is poor in comparison with epidural anaesthesia. PCB is a viable alternative to epidural in selected cases.

Cervix Uteri↗
PubMed2005

[Successful extracorporeal resuscitation of a probable perioperative anaphylactic shock due to atracurium].

We report the case of a 55-year-old woman ASA 2 scheduled for a cholecystectomy, who presented 25 minutes after the induction, a circulatory arrest probably due to a cardiac anaphylaxis attributed to atracurium. After 60 minutes of futile resuscitation without any spontaneous cardiac rhythm a percutaneous cardiopulmonary bypass (CPB) was initiated. Twenty minutes later and after three external electric shocks electric cardiac activity returned normal. The weaning was possible 120 minutes later with catecholamine support. She left the intensive care unit on postoperative day seven after a laparotomy secondary to splenic injury due to intensive cardiopulmonary resuscitation. She was discharged home without any neurologic or cardiac sequellae. Biological assessment done during the circulatory arrest and cutaneous tests performed ten weeks later confirmed an isolated allergy to atracurium. CPB is the most efficient support in case of reversible cardiac arrest but unfortunately the less accessible outside from cardiac surgery unit.

Anaphylaxis↗