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M Ossart

Publications and source records attributed to M Ossart.

At least 19 recordsLinked to original sources
PubMed1995

[Spinal anesthesia for disk herniation and lumbar laminectomy. Apropos of 77 cases].

77 spinal anaesthesias were performed over a 9-month period for surgical cure of herniated discs or lumbar laminectomy in knee-chest posture. Operating conditions were good or excellent in 66 patients (85.7%). Better results were obtained with lidocaine 5% than with bupivacaine 0.5% (both with fentanyl). Nine partial or total failures were recorded, eight of which in patients who underwent a preoperative radiculography and whose spinal anaesthesia was performed with bupivacaine. A likely explanation of these failures might be a leakage of local anaesthetic into the epidural space distended by radiopaque material. No intra or postoperative complications other than six transient hypotensions occurred. Despite of certain advantages, spinal anaesthesia cannot be recommended in all cases, particularly in patients at risk or if surgical time might be protracted. On the other way, ever possible failure obliges to inform preoperatively the patients that general anaesthesia cannot be excluded.

Aged↗
PubMed1994

[Esophageal perforation after transesophageal echocardiography].

Transoesophageal echocardiography (TOE) is increasingly used in cardiology, cardiac surgery and intensive care. Its complications are rare. We report a case of perforation of the oesophagus after TOE in a 71-year-old woman, scheduled for an elective aortic valve replacement. Her medical history included arterial hypertension but no pre-existing oesophageal disease. A Hewlett Packard ultrasound imaging system was used, with a 5 MHz single plane probe. After local anaesthesia, the transducer probe was inserted into the distal oesophagus, after three attempts, without any apparent incident. A few hours later, the patient complained of acute cervical and dorsal pain. Examination showed severe skin emphysema in of neck, but neither breathing difficulties, nor haemodynamic modifications. The EKG was normal and body temperature at 38.8 degrees C. The opacification of the oesophagus showed a passage of the contrast medium into the mediastinum. Emergency surgical exploration by left cervicotomy showed a perforation of 2 to 3 cm of the posterior wall of oesophagus, treated with terminal oesophagostomy and drainage. The pressure by the TOE probe on the oesophagus may explain this perforation. The outcome was uneventful. Although TOE is a semi-invasive technique with a low risks its benefit/risk ratio should be considered in each patients before using it.

Aged↗
PubMed1994

[Mechanical ventilation during MRI in children. Anesthetic constraints].

Early use of magnetic resonance imaging (MRI) excluded patients needing mechanical ventilation. However magnetic resonance imaging is an innocuous investigation and affords important elements to the diagnosis of many pathologies. Improvement of anaesthetic equipment have led to enlarge MRI applications considerably. Ventilations situated outside the MRI room required very long tubing, to 9-11 m. Although the ferromagnetic charge of presently used ventilators is greatly reduced, it is still necessary to keep them at some distance from the patient, with tubing of about 3 m, even in children. Therefore the compressible gas volumes are larger than the usual ones. For a tube length of 3 m, about 2-3 ml.kg-1 should be added to the standard tidal volume (10 ml.kg-1), so as to obtain safe normoventilation.

Anesthesia, General↗
PubMed1991

[Intravenous anesthesia for cesarean section. Comparison of propanidid and methohexital].

Propanidid and methohexital were compared retrospectively to assess the possible neonatal depression following general anesthesia for caesarean section: both have rapid onset and short duration of action and their transplacental passages are similar. Anesthesia was induced with equivalent doses of the two agents in 90 women (45 in each group). For each anesthetic agent, three subgroups were defined according to the indications, depending on emergency criteria and fetal state. There was no significant statistical difference (Student test) regarding clinical and biochemical criteria except for the fetal arterial pH which was more acidic in the propanidid group. In both groups, Apgar scores, arterial and venous pH were significantly more altered when caesarean section was performed for acute fetal depression.

Adult↗
PubMed1980

[Interest of prolonged peridural anaesthesia in the treatment of thoracic injuries (author's transl)].

Prolonged peridural analgesia relieves the pain and thanks to immediate return of ventilatory function avoids most complications of poor prognosis in mobile sternum. After a historical and pharmacological survey, the authors describe a standard technic, the course and the necessary supervision. The study of 29 cases of mobile sternum of variable gravity, treated in this way, permitted the authors to determine the indications and contra-indications and the role of associated treatments: physiotherapy, surgical fixation, respiratory assistance. The rare failures may benefit from another therapeutic method.

Adult↗
PubMed1976

[Seeking an ideal protocol for the stability of blood gases during general anesthesia for bronchosopies].

During general anesthesia for bronchoscopy, hypoxemia is a major risk, especially in patients with a severe intrapulmonary shunt. With the technique of apnea in pure oxygen, after one hour denitrogentation, and with an intake of 50 liters of oxygen per minute through the bronchoscope, the PaO2 was greater than 400 mm of Hg, but hypercapnia and acidosis occurred. To compensate the latter, five minute sessions of apnea, alternating with two minutes of jet hyperventilation, nevertheless, have the disadvantage of producing a Ventrui phenomena at the proximal end of the bronchoscope, hence a fall in FiO2 which was dangerous in these high risk patients. The authors propose a method so that the Venturi phenomenon, which cannot be prevented, occurs in pure oxygen.

Anesthesia, General↗