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Biomedical subjects

M T Cousin

Publications and source records attributed to M T Cousin.

At least 19 recordsLinked to original sources
PubMed1992

[Evolution of the blood levels of propofol administered by continuous perfusion during extracorporeal circulation].

The pharmacokinetics of propofol administered in continuous infusion was studied in 10 patients without left ventricular insufficiency during extracorporeal circulation (ECC) with hemodilution, for aortocoronary bypass. After a dosage of 1.5 mg.kg-1 during anaesthetic induction, the blood level was 4,800 micrograms.l-1. Under continuous infusion levels remained very high: they decreased by 40% during EEC induction and rose more than 10% when artificial ventilation started again. These modifications can be explained by physiological variations induced by EEC (non pulsated flow, redistribution, vasoconstriction, hemodilution, hypothermia) and they lead to adapt dosages in this type of anaesthesia.

Aged↗
PubMed1991

[Diaphragmatic paralysis after puncture of the internal jugular vein].

Two cases of paralysis of the diaphragm occurring after puncture of the internal jugular vein are reported. Both were old cancer patients, requiring an internal jugular venous catheter for intravenous feeding. Although the catheter was easily placed in both cases, the diagnosis of diaphragmatic paralysis was made postoperatively. The first patient remained asymptomatic, despite paradoxical breathing when lying supine; there was no change in her condition up to her death 4 months later. The second patient became increasingly breathless, with hypoxia and hypercapnia, during recovery from a gastrostomy under general anaesthesia. She required artificial ventilation, from which she could not be weaned and died 25 days later. A lesion of the phrenic nerve is possible when placing an internal jugular venous catheter, because they are closely related behind the sternocleidomastoid muscle. In the opposite to compression by a haematoma, or transient blockade following local anaesthetic infiltration, such a direct injury may be irreversible.

Aged↗
PubMed1991

[Anesthesia in a medical unit for treatment of trophic disorders of vascular origin].

The authors report here a first experiment of anaesthesia in a medicine unit. 29 anaesthesias were performed for 22 patients classed ASA II and III. The indications were nurses dressing for trophic troubles related to extremely painful vascular diseases. The whole treatment was realised in the medicine ward. Anaesthesia consists first in morphine injection as a premedication then several injections of propofol and alfentanil combined. The heart beat frequency was still and the blood pressure never lowered more than 10% of the preoperative level. No incident occurred. The awaking was of good value and without discomfort. The usual autonomy is regain in 2 hours after anaesthesia. This type of anaesthesia offers a new approach of painful cares and through a better dressing should lower the hospital stay.

Adult↗
PubMed1991

[Evaluation of epidural analgesia. Analysis of a prospective questionnaire answered by 100 women who delivered with epidural analgesia].

An enquiry was carried out by sending 368 women a double questionnaire at the eighth month of pregnancy and after delivery, in order to assess their opinions and motivations as far as epidural anaesthetic was concerned, and how far their expectations had been fulfilled. One hundred forms were returned. The sample was: 64% primipara and 36% multipara, of whom 64 women were married, 27 living in a stable relationship and 9 living on their own. 85% had a profession and 52% were in a higher social category. Eighty two of the women asked for an epidural in order to: in 58% of cases participate in their delivery, and in 31% of cases bond with the child. 57% hoped for less pain rather than for complete absence of pain which was asked for in 43%. Of the 36 multipara, 34 asked for epidural analgesia. Those who refused to have an epidural thought that they would be able to live through the delivery in a more natural way (44%) and 52% thought the process had become too medicalized and that complications of a medical nature might supervene. 33% gave no reason for refusing. This group contained more primipara (16) than multipara (2). These primipara thought that epidural analgesia would stop them taking part in the delivery and 10 of these knew that they would have pain in the delivery. Post partum replies showed that 58% had a higher opinion of epidural after than before the delivery and 93% were highly satisfied with the analgesia that they received. This despite the fact that the techniques were not perfect. Seven women thought the procedure unsatisfactory although there were no technical faults but the enquiry showed that they expected more from epidural analgesia. Whether they were satisfied or not, 98% of the women said that they would ask for epidurals in subsequent deliveries.

Adult↗