PubMed Health⌕ Search

Biomedical subjects

J-E Bazin

Publications and source records attributed to J-E Bazin.

7 recordsLinked to original sources
PubMed2006

Comparison of a propofol target-controlled infusion and inhalational sevoflurane for fibreoptic intubation under spontaneous ventilation.

BACKGROUND: A propofol target-controlled infusion (TCI) is often proposed for the management of difficult airway intubation and fibreoptic intubation under anaesthesia and spontaneous ventilation. No data are available about sevoflurane. The aim of the present study was to compare propofol and sevoflurane as hypnotics during fibreoptic intubation under spontaneous ventilation. METHODS: After regional ethical committee approval, 52 ASA I-II patients without any predictors for difficult intubation gave their informed consent. They were randomly assigned to one of two groups. After 3 min of pre-oxygenation, patients received either propofol with a plasmatic target concentration of 4 mg/l (group P; n= 26) or sevoflurane 4% with tidal volume ventilation (group S; n= 26). After 2 min, propofol was increased by 1 mg/l and sevoflurane was increased by 1% every 2 min until there was no reaction during mandible translation. This concentration was maintained for 4 min before starting nasotracheal fibrescopy for intubation. During both induction and fibrescopy, pulse oximetry, bispectral index (BIS), heart rate, and arterial blood pressure were monitored. Quality of intubation and operator satisfaction were evaluated. Data were compared using Student's t-test, Mann-Withney U-test or chi-square test. A P-value < 0.05% was considered to be significant. RESULTS: During induction, no difference in pulse oximetry, BIS values at the end of induction, or duration of induction were noticed. Five episodes of desaturation under 90% occurred during fibreoptic intubation in group P compared with none in group S. CONCLUSION: Sevoflurane provides good fibreoptic intubation conditions to spontaneously breathing patients without any hypoxemic episodes such as those observed with propofol.

Adolescent↗
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↗
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

[Laboratory animal anaesthesia: influence of anaesthetic protocols on experimental models].

The use of experimental animals requires anaesthesia to provide immobility and analgesia. Animals require anaesthesia not only for ethical reasons but also because pain and stress can alter the quality of research results. Recognition of pain, and its treatment is important throughout the procedure. Before anaesthesia, animals are acclimated and rehydrated. Except in small rodents and in ruminants, in order to avoid vomiting, a fast of 8 to 12 hours before anaesthesia is recommended. In order to protect animals against suffering and distress during transfer, restraint and management, a premedication is administered. Most human anaesthetic products can be used in animals. There are some specific veterinary anaesthetics. Moreover, the anaesthetic effects could be different from specie to an other. In most big animals, induction is realized by intravenous administration. In small rodents, venous puncture and contention could be difficult, and anaesthetic agents may be injected via intraperitoneal or intramuscular way. The principal inconvenient of these administration routes is the impossibility to adjust dose to animal response. In large animals, human anaesthesia material can be used. Some technical adaptations could be necessary in smaller animals. In rodents or in neonatology, specific devices are recommended. ECG, arterial pressure, tidal volume, expired CO(2) and oxygen saturation monitoring assess quality of, and tolerance to anaesthesia. If animals are awaked after anaesthesia, postoperative management is closed to human clinical problems. During animal experimentations, anaesthesia may interact with results. All anaesthetic drugs alter normal physiology in some way and may confound physiologic results. In the literature, most publications do not mention this possible interaction. Investigators need to understand how animals are affected by anaesthetic drugs in order to formulate anaesthetic protocols with minimal effects on data. Extrapolation between different animal species and human and animals about the effects of anaesthetic agents are very hazardous. Great differences exist between the effects observed in vitro and in whole animals. The effects of the anaesthetics could be totally different if they are used alone or in association. The same anaesthetic could have opposite effects from an organ to another. For results validation, the anaesthesia side effects (hypoventilation, hypotension, cooling em leader ) have to be minimized. All new experimental models should require discussing the possible interferences between anaesthesia and results and to compare results obtained with different anaesthetic protocols.

Anesthesia↗
PubMed2004

Generalized pustular psoriasis complicated by acute respiratory distress syndrome.

Psoriasis has a chronic and relatively benign course. However, severe complications are possible. One rare complication is acute interstitial pneumonitis. This entity should be suspected when a patient presents with dyspnoea and high fever. Knowledge of this pathology is crucial, for although it is essential to rule out aetiologies requiring specific management such as microbial infection or drug-related syndromes, diagnosis should not be delayed as its severe clinical course is improved by corticosteroids. We report two patients with an acute respiratory distress syndrome arising during the course of pustular psoriasis. Repeated bacteriological testing in lungs and blood remained negative. In both cases lung involvement was severe, requiring artificial ventilation. Dramatic clinical resolution was obtained by using corticosteroids. Besides infectious causes and drug hypersensitivity to methotrexate or acitretin, acute respiratory distress syndrome, sometimes due to a pulmonary capillary leak syndrome, is a rare cause of pneumonitis in the course of psoriasis, and may be fatal. Its pathogenesis is unknown. However, animal models suggest a role for T-helper (Th) 1 lymphocytes, known to be activated in psoriasis, and a role for tumour necrosis factor-alpha, a major Th1 cytokine, in alveolar damage.

Adult↗