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Biomedical subjects

M Palot

Publications and source records attributed to M Palot.

28 records · Page 2Linked to original sources
PubMed1994

[Epidemiology of complications of obstetrical epidural analgesia].

Epidural analgesia (EA) is the best technique to obtain pain relief during labour. But the needle, the catheter and the local anaesthetics (LA) are 3 reasons to cause maternal complications. In France we do not know the exact number of EA performed every year and it is very difficult to appreciate the incidence of maternal complications. Therefore, it is necessary to know it and try to reduce the incidence of some of them. Maternal complications after EA are classically: 1. caused by catheter or needle: massive subarachnoid injection, toxic intravenous injection with convulsions and/or cardiac arrest; 2. secondary to infectious problems: meningitis or epidural abscess; 3. due to LA with the very rare anaphylactoid reactions; 4. due to prolonged neurologic complications with epidural and subdural haematomas, subarachnoid cysts or arachnoiditis. These complications are rare: 1/4,700 in the largest series of literature, involving more than 500,000 EA. In France, we tried to quantify maternal complications among nearly 300,000 EA performed over a period of 5 years. The overall incidence of serious complications was 1/4,005 EA. The most frequent are accidental dural puncture (1/156), massive subarachnoid injections (1/8,010) and convulsions (1/9,011). The incidence of these 3 complications must be reduced by better training, material or attention during bolus injection of LA.

Abscess↗
PubMed1991

[Anesthesia for cesarean section and excision of pheochromocytoma caused by Sipple's syndrome].

A case of a 23-year-old primigravida with a tumour of the left adrenal gland and a medullary thyroid carcinoma is reported. Her blood pressure remained at about 100/60 mmHg throughout pregnancy. She was scheduled for elective Caesarean section combined with removal of both adrenal glands. Anaesthesia was carried out using 10 micrograms.kg-1 alfentanil, 5 mg.kg-1 thiopentone, 1.5 mg.kg-1 succinylcholine and 0.5 vol % enflurane. A single hypertensive crisis (190/100 mmHg) occurred intraoperatively, during dissection of the left adrenal gland. This responded well to 1 mg.min-1 phentolamine. The postoperative course was uneventful for both the mother and the child. Total thyroidectomy with block dissection of the lymph nodes was to be carried out within three weeks after the Caesarean section. Only two similar cases of multiple endocrine neoplasia associated with pregnancy have previously been published.

Adrenal Gland Neoplasms↗
PubMed1991

[Nocturnal paroxysmal hemoglobinuria disclosed during pregnancy. Apropos of a case].

Paroxysmal nocturnal haemoglobinuria (PNH) is a rare, acquired, intrinsic haemolytic anaemia believed to occur with an incidence of 1.5 per million in France. The disease is characterised by acute and chronic intravenous haemolysis and pancytopenia, without leukocytopenia. Pregnancy is rare and a high incidence of spontaneous abortion has been reported. The case reported here describes the successful outcome of a pregnancy where PNH was diagnosed. A 25 year old primigravida was admitted for evaluation of pancytopenia discovered in the 32nd week of an hypertensive pregnancy. On admittance R.B.C. were 1.67 x 10(12)/1, W.B.C. 3.4 x 10(9)/1 and platelets 12 x 10(9)/1; Hb was 6.8 g/dl and MGV 126 mu 3. Initial arterial pressure was 160/90 mm/Hg, with oedema and proteinuria 0.7 g per day. Obstetrical parameters were good and physical examination revealed to spontaneous haemorrhage, no jaundice, no dark urine, no organomegaly, no consumptive coagulopathy (C.C.) and no biological liver abnormalities. The patient received saline-washed packed red cells and fresh platelets. R.B.C. increased to 2.5 x 10(12)/1 and remained stable and platelets decreased to 5 x 10(9)/1 with increased arterial pressure and proteinuria, and appearance of C.C. A Caesarean section was performed, under general anaesthesia, and a male healthy baby weighing 2750 g was delivered. The post operative course was uneventful, except for a parietal haematoma which needed surgical evacuation. Because of the low platelet count, no heparin was given and the patient had no thrombosis and no infection.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1985

Mechanical ventilation with 100% oxygen does not increase intrapulmonary shunt in patients with severe bacterial pneumonia.

Pure oxygen ventilation has been shown to increase the right to left shunt QS/QT in both normal and diseased lungs. Nitrogen absorption atelectasis, an explanation of the phenomenon, is likely to occur in lung units with low ventilation/perfusion ratio. In 11 patients with severe unilateral or bilateral bacterial pneumonia, we assessed the effects of increasing FlO2 from maintenance level (m = 0.44 +/- 0.11) to 1.0. Venous admixture (QVA/QT) was calculated using the O2 method, and the distribution of the VA/Q ratios were assessed with the 6 inert gas (IG) technique providing the distribution between the true shunt (QS/QT IG) and the low VA/Q units. Although a large part of perfusion was distributed preferentially to low VA/Q units, ranging from 2 to 43% of cardiac output, thus placing large zones of lung parenchyma at risk of absorption atelectasis, QVA/QT decreased from 31 +/- 13% to 25 +/- 10% and IG shunt did not increase after 30 min of O2 ventilation. In addition, QS/QT IG remained unaltered despite PVO2 increased from 32 to 43 mmHg, suggesting a poor level of hypoxic vasoconstriction in human bacterial pneumonia.

Bacterial Infections↗
PubMedDate not supplied

[Abortion and the use of anaesthesia. Observations after two years' experience (author's transl)].

The authors give an account of their experience of anaesthesia in 380 abortion cases. Two kinds of technique were used: --paracervical block: 10.2 p. cent of the cases, only one complication; --narco-analgesia: considered to be essential. Dextromoramide was the principal analgesic used, chosen for its pharmacodynamic properties. Three narcotic drugs used successively in conjunction with this were: propanidine, with this drug per-anaesthetic complications and post-operative vomiting proved excessive, C.T. 1341 considerably reduced the frequency of these complications, disodic penthiobarbital did not give rise to any problems.

Abortion, Therapeutic↗