Biomedical subjects

L Lecron

Publications and source records attributed to L Lecron.

13 recordsLinked to original sources

PubMed1981

[Complications of loco-regional anaesthesia in obstetrical practice (author's transl)].

Complications of loco-regional anaesthesia in obstetrics are usually due to several factors: 1. choice of drugs: this must be judicious, taking into account duration of effect, potency and eventual maternal and foetal toxicity. This rule includes also morphinic drugs; 2. choice of technique: taking into consideration the stage of labour and also the eventual surgical procedure. Paracervical block must be avoided because of the numerous side-effects, chiefly foetal distress. Spinal anaesthesia is indicated only for instrumental procedures or caesarian section, with the usual reserves about headaches, severe hypotension. Peridural anaesthesia may present some complications, like extensive peridural anaesthesia, hypotension. In eclampsia and gemellarity, loco-regional, anaesthesia must be induced with the utmost caution. Moreover, an unrecognized uterine rupture may happen during labour under medullary anaesthesia if the patient had previously a caesarian section.

Anesthesia, Conduction↗

PubMed1980

[Comparative assays of various methods of medullary analgesia. Use of opiates (author's transl)].

Various methods of medullary analgesia are suggested using either the peridural or the subarachnoid technique. Spinal analgesia is much in demand in anaesthesia, in post-operative care or for the alleviation of chronic, mainly neoplastic, pain. Anaesthesia is obtained with a local anaesthetic acting at the level of the membrane. The adjunction of an opiate, acting at the level of the medullary morphinic receptors, enhances local anaesthesia both in depth and duration. This association allows lesser concentrations and volumes of drugs to be used. Various opiates have been tested: their effect depends on the type of administration (I. V., intra-medullary). In the case of intra-medullary injection these is also a difference in the action of the drug according to the technique used (peridural or subarachnoid). The meningeal barrier plays a major function, preventing the diffusion and fixation on the morphinic receptors of some drugs administered peridurally. The action of these drugs, when injected by the subarachnoid technique, is enhanced; this is the case of morphine-base. Others according to their physicochemical characteristics cross easily the dura mater and are very active when injected peridurally. Opiates are also used for the alleviation of chronic pain and are quite as effective as local anaesthetics, steroids or hypertonic saline by peridural injection. The main interest of these techniques lies in the easy reversibility of the analgesia.

Analgesia↗

PubMed1979

Domperidone in the prevention of post-operative nausea and vomiting.

In a series of open pilot studies, intravenous domperidone was given to three groups of post-operative patients, at doses ranging from 10 mg to 60 mg. As a result of these studies, it was decided that a regime of 20 mg initially, followed by maintenance doses of 10 mg at 6 hourly intervals was highly effective in preventing post-operative nausea and vomiting. Consequently this regime was chosen to evaluate domperidone against placebo in a double-blind study involving 106 patients. The results showed that only three out of 53 patients (5.7%) on active treatment were having nausea and vomiting compared with 16 of 53 patients (30.2%) on placebo. It is concluded that this regime is effective in preventing post-operative nausea and vomiting.

Antiemetics↗

PubMed1979

Blood saving techniques: indications and contraindications.

Pre- and peroperative blood saving can be realised in different ways, without inducing important changes in the biological parameters of the organism. Different replacement solutions are studied in detail. Three principal techniques are as follows: a) The peroperative autotransfusion consists in recovering the blood lost in the operative field during the surgical intervention, filtering it and transfusing it at the end of surgery. b) The peroperative normodilution consists in collecting a certain amount of blood (till up 2 l.) from the patients before operation; it is replaced by plasma expanders and transfused at the end of operation. c) The third technique, called the 'frog leap', consists in collecting blood during the weeks preceding surgery, in various amounts in function of the importance of the estimated blood loss. This blood is stored and transfused during intervention.

Blood Preservation↗

PubMed1976

[Role of peridural anesthesia in thoracic surgery].

Periduralaneaesthesia by the cervical route (C6-C7 or C7-D1) or by the upper lumbar route with an ascending catheter, permit thoracic surgery in all its applications. The reduction in operative bleeding is an appreciable advantage of the method, and automatic nervous stability is remarkable. On the other hand, keeping the patient in the waking state is a definite disadvantage, especially in removal of one lung. As far as the anaesthetist is concerned he will be faced with difficulties of ventilation and bronchial aspiration. On the other hand, combined with slight general anaesthesia and tracheal intubation, peridural anaesthesia is definitely of interest. Furthermore, during the post-operative period, it is precious permitting a cough without pain and, in this respect, the comparison with anaesthesia of the inter-costal nerves, is worth discussins, each technique having special advantages.

Anesthesia, Epidural↗

PubMed1974