PubMed Health⌕ Search

Biomedical subjects

M Boussofara

Publications and source records attributed to M Boussofara.

11 recordsLinked to original sources
PubMed2004

[Clonidine and anesthesia].

The alpha2-adrenoceptor agonists have several beneficial actions during the perioperative period. They exert a central sympatholytic action, improving haemodynamic stability in response to endotracheal intubation and surgical stress, reducing the anesthetic and opioid requirements and causing sedation, anxiolysis and analgesia. Furthermore, alpha2-adrenoceptor agonists may offer benefits in the prophylaxis and treatment of perioperative myocardial ischaemia. Recent alpha2-adrenoceptor agonists with short duration of action (dexmedetomidine and mivazerol) are adapted for the administration to patients at high risk for coronary artery disease during surgery. The alpha2-adrenoceptor agonists have an analgesic action at several sites of the peripheral and central nervous system as well as the prolongation of epidurally or intrathecally administered local anesthetics and opioids.

Adrenergic alpha-Agonists↗
PubMed2002

[Place of normovolemic hemodilution in oncologic cervicofacial and ENT surgery].

OBJECTIVE: Evaluate the use of normovolaemic haemodilution in cervico-facial oncologic surgery. STUDY DESIGN: Prospective, randomised, simple blinded study. PATIENTS AND METHODS: 38 ASA I and II patients were studied: a control group (n = 21) and a haemodilution group (n = 17) in whom 5.5-8 mL.kg-1 blood were withdrawn before induction, replaced by an equivalent amount of colloids. In both groups, the transfusional strategy was to keep the haemoglobin level above 100 g.L-1 throughout the procedure and the recovery phase, using in priority the autologous blood in the haemodilution group. Blood losses during surgery were evaluated by weighing the sponges and by measuring the aspirated blood. RESULTS: Demographic and anaesthetic data, and blood losses were similar. The haemoglobin levels dropped significantly in the haemodilution group (138 +/- 10 g.L-1 to 107 +/- 11 g.L-1) as well as in the control group (131 +/- 11 g.L-1 to 110 +/- 10 g.L-1). Infectious complications were slightly higher in the haemodilution group, although this difference did not reach the level of significance. CONCLUSION: Normovalaemic haemodilution does not seem to be indicated in cervico-facial and ENT oncologic surgery.

Aged↗
PubMed2001

Comparison of the effects of clonidine and hydroxyzine on haemodynamic and catecholamine reactions to microlaryngoscopy.

BACKGROUND AND OBJECTIVE: This study compares the effect of oral clonidine vs. hydroxyzine on the haemodynamic and catecholamine responses to microlaryngoscopy. METHODS: Thirty-five ASA II-III patients were included in this double-blind randomized trial. The patients received either hydroxyzine 1 mg kg-1 (n = 18) or clonidine 3 micrograms kg-1 (n = 17) for their oral premedication 100 min before an intravenous induction of anaesthesia using propofol (2-3 mg kg-1) and fentanyl (2 micrograms kg-1). Arterial pressure and heart rate were measured before premedication, and throughout the procedure and recovery. Plasma catecholamine levels were determined before premedication, after induction, and 1.5, 30 and 120 min after laryngoscopy. RESULTS: Mean arterial pressure was significantly lower after clonidine, whereas there was no difference in heart rate and plasma catecholamine levels between the two groups. CONCLUSIONS: Clonidine for premedication significantly decreased mean arterial pressure during microlaryngoscopy and the following recovery phase but did not modify the overall haemodynamic response to the suspension microlaryngoscopic nociceptive stimulus.

Adrenergic alpha-Agonists↗
PubMed2001

[Autologous versus homologous transfusion in cervico-fascial oncologic and ENT surgery].

The objective was to evaluate the interest of the normovolemic hemodilution (NVH) in cervico-facial oncologic and ENT surgery. It was a prospective, randomised and simple blind study having included A(n = 17) having benefitted before induction of a blood withdrawal of 6-8 ml.kg-1, substituted by an intravenous drip of colloid. B group (n = 21). The transfusional objective having been to assure for the two groups, during operative and in postoperative periods, a rate of Hb > or = 10 g.dl-1 and a rate of Ht > or = 30%. The two groups were comparable for the demographic and anesthetic characteristics, and the blood losses during operative period. A variation significantly more important between before and postoperative hemoglobin has been objectified in the group A. The infectious morbidity was significantly more elevated in the group A (23.5% versus 4%). The cost was distinctly more elevated in the hemodiluted group. The NVH doesn't seem to be an indication of choice in the cervico-facial and ENT oncologic surgery.

Aged↗
PubMed2001

[Control of hemodynamic variations secondary to suspension microlaryngoscopy].

The objective was to evaluate the clinic interest of the esmolol in the attenuation of the hemodynamic response to suspension microlaryngoscopy (mls). It was a prospective, randomized and double blind study, having included 29 patient ASA II and III, distributed in two groups, having received respectively before laryngoscopy: group A (n = 15), esmolol in intravenous (i.v.) at the dose of 150 micrograms.kg-1 and DS group (n = 14), 10 ml of normal saline at 0.9%. Has been achieved a general anaesthesia i.v. based on propofol, fentanyl and atracurium. After tracheal intubation, it has been assured an artificial ventilation. The two groups were comparable for the demographic and anesthetic characteristics. A significant decrease of the mean arterial pressure (-11%) and of the prp (product systolic arterial pressure heart rate) have been raised during the mls, in the group esmolol, whereas the variations of the cardiac frequency were comparable. In order to assure a better hemodynamic control during the mls, it seems important, in addition to the adjustment of the recommended dose of esmolol, to cover the whole duration of the endoscopic act by a continuous drip.

Adrenergic beta-Antagonists↗
PubMed1994

[Acid-base equilibrium and the brain].

In physiological conditions, the regulation of acid-base balance in brain maintains a noteworthy stability of cerebral pH. During systemic metabolic acid-base imbalances cerebral pH is well controlled as the blood/brain barrier is slowly and poorly permeable to electrolytes (HCO3- and H+). Cerebral pH is regulated by a modulation of the respiratory drive, triggered by the early alterations of interstitial fluid pH, close to medullary chemoreceptors. As blood/brain barrier is highly permeable to Co2, CSF pH is corrected in a few hours, even in case of severe metabolic acidosis and alkalosis. Conversely, during ventilatory acidosis and alkalosis the cerebral pH varies in the same direction and in the same range than blood pH. Therefore, the brain is better protected against metabolic than ventilatory acid-base imbalances. Ventilatory acidosis and alkalosis are able to impair cerebral blood flow and brain activity through interstitial pH alterations. During respiratory acidosis, [HCO3-] increases in extracellular fluids to control cerebral pH by two main ways: a carbonic anhydrase activation at the blood/brain and blood/CSF barriers level and an increase in chloride shift in glial cells (HCO3- exchanged for Cl-). During respiratory alkalosis, [HCO3-] decreases in extracellular fluids by the opposite changes in HCO3- transport and by an increase in lactic acid synthesis by cerebral cells. The treatment of metabolic acidosis with bicarbonates may induce a cerebral acidosis and worsen a cerebral oedema during ketoacidosis. Moderate hypocapnia carried out to treat intracranial hypertension is mainly effective when cerebral blood flow is high and vascular CO2 reactivity maintained. Hypocapnia may restore an altered cerebral blood flow autoregulation. Instrumental hypocapnia requires a control of cerebral perfusion pressure and cerebral arteriovenous difference for oxygen, to select patients for whom this kind of treatment may be of benefit, to choose the optimal level of hypocapnia and to avoid any deleterious effect. If hypocapnia is maintained over several days, an adaptation of CSF pH may limit the therapeutic effect on the cerebral blood flow and the intracranial pressure.

Acid-Base Equilibrium↗
PubMed1994

Intraoperative glycaemic control in non-insulin-dependent and insulin-dependent diabetes.

We have compared intraoperative glycaemic control, insulin requirements and metabolic and endocrine variables in 40 non-insulin-dependent diabetic patients (NIDDM) and 40 insulin-dependent diabetic patients (IDDM) undergoing general anaesthesia for elective procedures. Two i.v. insulin regimens were used: continuous i.v. infusion (group A: 1.25 u.h-1) and repeated i.v. boluses (10 u./2 h). Blood concentrations of glucose were measured every 15 min from just before induction of anaesthesia until 2 h after surgery. Plasma lactate and pyruvate concentrations, ketone bodies, C-peptide and counter-regulatory hormones were also measured. Glycaemia did not differ significantly in the two types of diabetes, regardless of the insulin therapy used. The amounts of insulin administered were similar in NIDDM and IDDM. There was no significant difference for other metabolic variables. Plasma concentrations of growth hormone (GH) increased significantly during surgery, especially in IDDM patients, but this change did not alter intraoperative glycaemic control. We conclude that mean glycaemic control, insulin requirements and development of ketone bodies in NIDDM and IDDM patients did not differ during the operative period, regardless of the insulin regimen used. Therefore, during the operative period, it is not necessary to modify the insulin regimen according to the type of diabetes. The consequences of increased plasma GH concentrations on glycaemic control in IDDM patients after operation are unknown.

Adult↗