Biomedical subjects

L Cyrenne

Publications and source records attributed to L Cyrenne.

3 recordsLinked to original sources

PubMed1996

Patient-controlled analgesia after spinal fusion for idiopathic scoliosis.

One hundred adolescents undergoing posterior spinal fusion for scoliosis were reviewed to assess the adequacy of postoperative patient-controlled analgesia. There were 94 females and 6 males. The mean settings for morphine dosage were a loading dose of 114.5 micrograms.kg-1, a bolus dose of 24.8 micrograms.kg-1, and a lockout interval of 9.9 minutes. This was used for an average of 75.8 h, with a 52.2% success rate. Adolescents using patient-controlled analgesia showed a great variability in morphine requirements with greater use as they became older. The requirement was not significantly different on the 1st, 2nd and 3rd postoperative days and the total consumption was 52.2 micrograms.kg-1.h-1. Nausea and vomiting occurred in 45% and pruritus in 15%. There were 7 cases of respiratory depression who all recovered promptly and completely. This method is associated with high morphine requirements in adolescents, but can be used safely.

Adolescent↗

PubMed1991

Residual curarization in the neonate after caesarean section.

The transplacental transfer and the neonatal effects of atracurium 0.3 mg.kg-1 (ED95) were compared with those of d-tubocurarine at the usual clinical dose of 0.3 mg.kg-1 (ED90) in 46 patients undergoing elective Caesarean section. The atracurium group (25 patients) was similar to the d-tubocurarine group (21 patients) as far as age, parity and time intervals between precurarization, induction, skin incision, muscle relaxant administration, hysterotomy and birth. The transplacental transfer of atracurium was lower than that of d-tubocurarine, with a feto-maternal ratio of 9 +/- 3% for atracurium and 12 +/- 5% for d-tubocurarine (P less than 0.05). The transplacental transfer of laudanosine was low at 14 +/- 5%, with blood levels of 0.101 +/- 0.032 microM.L-1 in the umbilical vein. Newborns in the two groups were comparable in terms of Apgar scores at one, five and ten minutes, as well as for NACS scores (neurological and adaptive capacity scoring test) at two and 24 hours after birth. However, at 15 min after birth, only 55% of newborns in whom the mothers received atracurium had a normal NACS score (greater than or equal to 35/40) compared with 83% of newborns in whom the mothers received d-tubocurarine (P less than 0.05). Further analysis of the five variables related to active muscle tone revealed that the modal score for active extension of the neck of newborns from the atracurium group was lower than for newborns from the d-tubocurarine group (P less than 0.01).(ABSTRACT TRUNCATED AT 250 WORDS)

Anesthesia, Intravenous↗

PubMed1988

The oculorespiratory reflex revisited.

Continuous measurement of the intratracheal pressure and capnography are very simple and accessible methods for the detection and recording of the oculorespiratory reflex (ORR). Eight healthy children (five to 14 years old) undergoing strabismus surgery under halothane-nitrous oxide anaesthesia with spontaneous ventilation were studied. The ORR was evoked by traction on the extrinsic muscles of the eye (four medial recti and four lateral recti). Slowing of the respiratory rate and/or shallow respiratory movements were observed in each patient. One patient developed apnoea of 20 seconds duration which forced the use of manually controlled ventilation. Intravenous atropine (0.01 mg.kg-1) reduced the incidence of positive OCR (to 37.5 per cent) but did not diminish the incidence of the ORR (100 per cent). Since the ORR may lead to hypercapnia and hypoxaemia, controlled ventilation is recommended for patients undergoing strabismus surgery at least immediately before and during the muscular traction. It is now clear that the ORR may be evoked by traction on the extrinsic muscles of the eye, may produce hypercapnia and hypoxaemia and so, may aggravate the consequences of the OCR.

Adolescent↗