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M Soetens

Publications and source records attributed to M Soetens.

14 recordsLinked to original sources
PubMed1997

Uptake of desflurane and isoflurane during closed-circuit anesthesia with spontaneous and controlled mechanical ventilation.

Although theoretical models predict uptake of inhaled anesthetics during closed-circuit anesthesia (CCA), clinical data for most anesthetics are conflicting or non-existent. In addition, the effects of patient characteristics and mode of ventilation on anesthetic uptake are unclear. Forty-one ASA physical status I or II adult patients undergoing a variety of 1-1.5 h surgical procedures were randomly allocated to receive CCA with desflurane or isoflurane with ventilation being either spontaneous or controlled. An end-expired anesthetic concentration of 1.3 minimum alveolar anesthetic concentration (MAC) was maintained by continuous injection of the liquid anesthetic into the circuit using a syringe pump. After an initial 4-min wash-in period, uptake during the first hour of CCA was nearly constant. Uptake was the same whether ventilation was spontaneous or controlled. Patient characteristics (age, height, weight, weight3/4, and body surface area) were comparable between groups and did not correlate with uptake. The virtually constant uptake after wash-in of desflurane and isoflurane contrasts with the square root of time model of Lowe and Ernst. These findings may greatly simplify CCA.

Adult↗
PubMed1996

Carboxyhemoglobin concentrations during desflurane and isoflurane closed-circuit anesthesia.

Desflurane has been implicated in carbon monoxide (CO) intoxication during general anesthesia under certain circumstances. Carboxyhemoglobin (COHb) concentrations were determined in forty-one patients who were randomly allocated to receive closed-circuit anesthesia (CCA) with 1.3 MAC of desflurane (n = 21) or isoflurane (n = 20) in oxygen. Soda lime was used to bind the produced CO2 in previous anesthetic procedures with fresh gas flows of < 21/min. In the desflurane group, COHb concentrations (mean +/- SD) were 0.86 +/- 1.15% and 0.81 +/- 1.11% before and after 1 h of anesthesia, respectively. In the isoflurane group, COHb concentrations were 1.15 +/- 1.47% and 1.19 +/- 1.39% before and after 1 h of anesthesia, respectively. COHb concentrations did not increase after 2 h of CCA in seven patients. Our data suggest that closed-circuit anesthesia with desflurane or isoflurane does not produce clinically significant increases in COHb concentrations under conditions that allow the soda lime to remain sufficiently wet.

Adult↗
PubMed1996

Sore throat with the laryngeal mask: does the lubricant matter?

In daily anesthetic practice, the insertion of a Laryngeal Mask--airway is facilitated by means of a lubricant. Many different products are in widespread clinical use, according to personal preference or what's in or on the anesthesia trolley. This study compares four different lubricants: Xylocaine 10% spray, Silkospray, Endosgel and water. When comparing the ease of insertion of the Laryngeal Mask, the genuine lubricants proved to be superior to water. However, no single lubricant was associated with a statistically significant lower incidence of postoperative sore throat.

Anesthetics, Local↗
PubMed1991

The effects of the addition of sufentanil to 0.125% bupivacaine on the quality of analgesia during labor and on the incidence of instrumental deliveries.

In a double-blinded, randomized, prospective multi-center study of 695 women, we investigated whether epidural injection of sufentanil added to 0.125% bupivacaine with epinephrine (1:800,000) reduces the total amount of local anesthetic required, resulting in less motor blockade and reduced incidence of instrumental deliveries, and improves the quality of analgesia provided by this low concentration of local anesthetic without jeopardizing the safety of the baby. In addition, other potential benefits of sufentanil (such as decrease in the incidence of shivering) and side effects were examined. It was found that adding incremental doses of 10 micrograms sufentanil up to a maximum of 30 micrograms reduced the incidence of instrumental deliveries from 36 to 24% (P less than 0.01) and significantly improved quality and duration of analgesia without depressing the neurobehavioral status of the baby. No other benefits from adding sufentanil were found. The only side effect that occurred more frequently after sufentanil was pruritus. We conclude that epidural injection of 10-30 micrograms sufentanil added to 0.125% bupivacaine with epinephrine (1:800,000) improved the quality of analgesia during labor and reduced the incidence of instrumental deliveries without jeopardizing the safety of the baby.

Adult↗
PubMed1986

Extradural analgesia and retinal haemorrhage in the newborn.

The incidence and severity of retinal haemorrhage were examined in 976 babies born by vaginal delivery. The influence of the method of analgesia, instrumental delivery and parity was studied. The mothers of 638 infants received extradural analgesia, while the other 338 received either narcotics or no analgesia. Extradural analgesia did not lead to a higher incidence of retinal haemorrhage, even though the number of vacuum extractions was doubled. With increasing parity, the total frequency and the frequency of severe retinal haemorrhage decreased (P less than 0.001). Severe retinal haemorrhage was not seen in any baby of whom the mother was para 4 or more.

Anesthesia, Epidural↗
PubMed1979

Bupivacaine, 0.125 per cent, in obstetric epidural analgesia: experience in three thousand cases.

Bupivacaine, 0.125 per cent, with epinephrine, 1:800,000, was administered to 3,000 women in labor. Administration was in the lumbar epidural space for the purpose of achieving satisfactory analgesia with minimal or no motor paralysis. The usual initial dose of 12.5 mg (mean 13 +/- 2 SD) resulted in good sensory analgesia in 83 per cent of the patients and lasted for about and hour (mean 58 +/- 16 min). The mean total dose used for labor and delivery was 55 +/- 20 mg and the mean dose per hour 23 +/- 13 mg. Satisfactory analgesia for labor and delivery was obtained in 92 per cent of the patients, and in 66 per cent there was no discernible motor blockade. In the 3,000 patients, there was no adverse reaction to bupivacaine or epinephrine. No patient had a total spinal block or neurologic sequelae, and no neonatal depression could be attributed to the anesthetic.

Anesthesia, Epidural↗