[Tomodensitometry in infectious brain syndromes].
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Biomedical subjects
Publications and source records attributed to M Sabathié.
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On the basis of the analysis of fifteen cases of children weighing less than ten kg, in a department of neurosurgery, the authors describe the use of Alfatésine by infusion in association with a morphinomimetic, a technique compatible with the existence of raised intracranial pressure. In view of the weight of the children, availability of a venous line represents a handicap and a danger to such an extent that the authors suggest limited assistance in the form of sedation by a halogenated agent, with the application of strict rules concerning dose and surveillance, bearing in mind its effects on intracranial pressure. The quality of anesthesia and of recovery is emphasised and the doses described. The effects of Alfatesine and of Fentanyl on intracranial pressure, cerebral metabolism and blood flow are reviewed. These favourable effects justify the use of Alfatesine in this context. One case of obvious overdose, responsible for delayed recovery, is discussed.
After a review of the various techniques used in difficult intubations, the authors emphasize recent progress in the field of fiber endoscopy. The advantages of this technique, e.g. absence of trauma, increased field of exploration and reduction in dose of anaesthetic drugs, exceed the present disadvantages, e.g. high price of this material, relatively fragile apparatus, too long and diameter too great for use in children.
Etomidate or R 26490 is a new hypnotic agent produced by JANSSEN and al. in 1971. The first human experimentation was performed in 1972. The authors used Etomidate for 300 anaesthetics given for neuroradiological investigations. Two protocols were used for study: 25 anaesthetics were given with Etomidate as sole anaesthetic to outline its specific properties; 275 angiographies were performed with a combination of Etomidate and fentany1. In protocol no 1, the mean consumption was for 1,85 mg/kg/h, in protocol no2, the mean consumption was of 0,9 mg/kg/h. Pharmacological study of this drug defines it as a short acting hypnotic agent of low toxicity. Clinical observation shows cardiovascular and respiratory stability. However, frequent myoclonias were noted, when Etomidate was given as a sole anaesthetic. EEG recording and evoked response encephalography helped to outline some effects of Etomidate on central nervous system.
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The authors bring not only the results of their experience but a solution of the respiratory problems during anaesthesia in suspension laryngoscopy, thanks to the devising of a new intubation probe and a pre-set automatic insufflator with varying volum flow.
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