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M Viallard

Publications and source records attributed to M Viallard.

6 recordsLinked to original sources

Antimicrobial prophylaxis for major head and neck cancer surgery with piperacillin and ornidazole.

A prospective study in 53 eligible patients, undergoing major head and neck cancer surgery was carried out to assess the combination of an ureido penicillin, piperacillin with a nitro imidazole agent, ornidazole, in order to prevent post-operative general and wound infections. Both antibiotics were administered for five days. Each patient had piperacillin 4 gm every eight hours and ornidazole 1 gm every 24 hours. The overall rate of infections was 13.2 per cent (n = 7), with 3.8 per cent (n = 2) wound infections and 11.3 per cent (n = 6) general infections (one patient presented both complications). There was no wound infection in the total surgery group (n = 12). General infections who only consisted of pneumonias were respectively 12.2 per cent (n = 5) in the group with partial procedures (n = 41) and 8.3 per cent (n = 1) in the total surgery group. This antibioprophylaxis can be recommended in major oncological neck surgery, specially in the case of partial procedures.

Adult↗

[Respiratory tract obstruction caused by ballooning of an intubation tube cuff during nitrous oxide inhalation].

A typical case of upper airway obstruction due to deformation of a low pressure tracheal tube cuff is reported. It would seem that this herniation may have been due to nitrous oxide diffusing with in the air-filled cuff, thereby causing it to overdistend. This increase in pressure occurred after 3 hours of inhalation of a mixture of oxygen and nitrous oxide. The deformed cuff may either block the lumen at the end of the tube, or push the tube against the tracheal wall. The result is, in either case, a mechanical obstruction of the airway, with hypoxia, and then anoxia. In the reported case, it was the decrease of SpO2 which alerted the anaesthetist. Pulse oximetry was helpful for an early diagnosis. To avoid such accidents, it is suggested either to inflate the cuff with the gas mixture with which the patient is ventilated, or to deflate it every 30 min.

Adult↗