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Biomedical subjects

P Deligne

Publications and source records attributed to P Deligne.

9 recordsLinked to original sources
PubMed1992

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↗
PubMed1991

[Pharmacokinetics of continuous infusion of etomidate in cirrhotic patients].

The pharmacokinetics of etomidate were studied in 9 control subjects (with normal liver function) and in 5 patients with cirrhosis scheduled for gastro-intestinal surgery. Anaesthetic induction included an initial bolus of etomidate 0.3 mg.kg-1, together with fentanyl 2 micrograms.kg-1, and pancuronium 60 micrograms.kg-1. An etomidate infusion was then started according to one of two following schemes: a (0.03 mg.kg-1.min-1 for 10 min, and then 0.01 mg.kg-1.min-1), or B (0.1 mg.kg-1.min-1 for 10 min, followed by 0.02 mg.kg-1.min-1 for a further 110 min, and 0.01 mg.kg-1.min-1 thereafter). Plasma concentrations of etomidate were determined at regular intervals throughout anaesthesia, and up to four hours afterwards, using inverse phase high pressure liquid chromatography. The infusion was given for 273 +/- 87 min in controls, and for 259 +/- 56 min in the cirrhotic group. Scheme A, only used in 3 controls and 1 cirrhotic in a preliminary study, resulted in very low plasma concentrations: 0.2 to 0.4 micrograms.ml-1. Those measured during the apparent plateau phase (steady state) of infusion protocol B were close to predicted values (0.5 to 0.6 micrograms.ml-1) in controls, whereas higher concentrations (approximately 1.5 micrograms.ml-1) were reached in cirrhotic patients. For all the patients the time interval to spontaneous recovery was 41 +/- 27 min; plasma levels were then 0.199 +/- 0.092 micrograms.ml-1. There were significant alterations in pharmacokinetic parameters in the cirrhotic patients.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1989

[Anesthesia in high class athletes].

A case of general anaesthesia in a 49 year old male, high level specialist in triathlon, is reported. At the preoperative assessment, the patient had a sinus bradycardia of 45 b.min-1. The electrocardiogram (ECG) exhibited 2 mm ST segment elevation in leads V3-V5, an inverted T wave in leads V1 and V4, and a prolonged QT interval. The QRS axis was 60 degrees, the Sokolow index 44 mm; there was a partial right bundle branch block. These ECG anomalies disappeared during exercise. Heart sounds and blood pressure were normal. On chest X-ray the heart was enlarged. Five mg of midazolam were given orally 30 min before induction, and 1 mg atropine intravenously to increase the heart rate (40 b.min-1). Anaesthesia was induced with 2.5 mg.kg-1 propofol and alfentanil 15 micrograms.kg-1. Vecuronium 0.05 mg.kg-1, alfentanil 0.5 mg, 0.5% isoflurane in a mixture of 40% oxygen and 60% nitrous oxide were used to maintain anaesthesia. A further bolus of 0.5 mg atropine was necessary because of persisting sinus bradycardia. Surgery lasted 70 min. Heart rate and blood pressure returned to their initial values when the patient recovered from anaesthesia. Cardiac abnormalities are common in athletes; they must be distinguished from pathological conditions. When carrying out anaesthesia in these patients, it would seem highly recommendable to give 1-2 mg atropine, and to avoid associating negative chronotropic drugs.

Anesthesia, General↗
PubMed1982

Maternal and fetal concentration of morphine after intrathecal administration during labour.

Twenty-five healthy women in labour received morphine 1-1.75 mg in normal saline intrathecally. The residual pain was evaluated on a scale from 0 to 5 at 10 min (score 2.5) and at 25 min (score 1.5). After delivery the maternal and fetal plasma morphine concentrations were measured by radioimmunoassay in 14 parturients. Twenty-three women of 25 had vaginal deliveries, 20 of them without forceps. The maternal and fetal plasma concentrations of morphine were 6 ng ml-1 or less. The intrathecal (but not extradural) administration of morphine is effective and could provide an interesting alternative for pain relief in labour.

Anesthesia, Obstetrical↗
PubMed1982

[Effects of flunitrazepam on intraocular pressure (author's transl)].

Though ophthalmologists operate upon patients that are in a debilitated state, a general anesthesia has to be employed with increasing frequency. Flunitrazepam, known to possess good cardiovascular tolerance, was studied to evaluate its effects on intraocular pressure in 34 unselected patients undergoing 41 operations under general anesthesia, usually 41 operations under general anesthesia, usually for retinal detachment or cataract. Ocular pressure was normal in all cases before surgery, but a history of chronic respiratory insufficiency was obtained in 8 cases and of cardiovascular disease in 18. After premedication with 0.02 mg . kg-1 of flunitrazepam and 0.01 mg . kg-1 of atropine, anesthesia was induced by 0.04 mg . kg-1 i.v. of flunitrazepam alone. No marked alterations in cardiac of respiratory functions were observed. Intraocular pressure was measured with a Schiötz tonometer, just before and 5 minutes after the i.v. injection of flunitrazepam. Results showed -- before: 1.61 +/- 0.51 kPa (12.1 +/- 3.8 mmHg); after: 1.09 +/- 0.36 kPa (8.2 +/- 2.7 mmHg) -- a statistically reduction of 32 p.cent. The precise mechanism of action of flunitrazepam on intraocular pressure is not known, but cannot be related to the reduction in aqueous humor secretory flow or the marked diminution in arterial or venous pressure. A probable explanation is the lowering of resistance to aqueous humor flow exterior to the ocular globe as a result of the muscle relaxant properties of the product. Flunitrazepam appears to be a narcohypnotic of choice in ophthalmological surgery on these inherently debilitated patients.

Adolescent↗