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Biomedical subjects

Pierre Drolet

Publications and source records attributed to Pierre Drolet.

7 recordsLinked to original sources
PubMed2007

Performance of the PAxpress vs the ProSeal laryngeal mask airway during general anesthesia.

PURPOSE: The PAxpress (PAx) is a relatively new pharyngeal airway device that is easily inserted and effective in routine airway management. A prospective, randomized study was undertaken to compare the PAx with the ProSeal laryngeal mask airway (PLMA) during anesthesia with positive pressure ventilation. METHODS: One hundred adult patients scheduled for elective surgery under general anesthesia were randomized to airway management with either the PAx (n=50) or the PLMA (n=50). All patients swallowed a methylene blue capsule before anesthesia. After insertion, leak and inspiratory pressures were measured. Fibrescopy was used to view the glottis. Devices were inspected for blood or methylene blue staining upon removal at the end of surgery. An interview was conducted postoperatively to evaluate the occurrence of sore throat, dysphagia and dysphonia. RESULTS: Insertion time was longer for the PAx than for the PLMA (52 +/- 44s vs 34 +/- 23 sec; P=0.003). Leak pressure was lower while peak inspiratory pressures, and EtCO2 values were higher (P=0.016; 0.027 and 0.04 respectively) with the PAx. Both devices provided comparable fibreoptic viewing of the glottis. There were no differences with respect to the incidence or pattern of blue stains upon removal. Blood was seen more often on the PAx (58% vs 19%) and dysphagia was also more frequent and severe with the PAx. CONCLUSION: In comparison with the PLMA, PAx insertion time is longer and the ventilatory characteristics of this new device may be marginally inferior. The PAx is also more traumatic and is associated with more postoperative discomfort compared to the PLMA.

Adult↗
PubMed2006

A multimodal analgesia protocol for total knee arthroplasty. A randomized, controlled study.

BACKGROUND: Although numerous methods of postoperative analgesia have been investigated in an attempt to improve pain control after total knee arthroplasty, parenteral narcotics still play a major role in postoperative pain management. Local anesthetics have the advantage of blocking pain conduction at its origin and minimizing the systemic side effects associated with postoperative narcotic use. This study was performed to evaluate the benefits and safety of a multimodal analgesia protocol that included periarticular injection of large doses of local anesthetics in patients undergoing total knee arthroplasty. METHODS: We compared morphine consumption during the first twenty-four hours after unilateral total knee arthroplasty in forty-two patients who had been randomized to receive either (1) a perioperative infiltration mixture, consisting principally of local anesthetic, and self-administered morphine or (2) self-administered morphine only. Narcotics consumption, pain control, medication-related side effects, plasma levels of the local anesthetic (ropivacaine), and postoperative rehabilitation were monitored. RESULTS: Although there was high satisfaction and good pain control in both groups, morphine consumption was significantly lower in the local analgesia group than it was in the control group (28.8 +/- 17.4 mg compared with 50.3 +/- 25.4 mg twenty-four hours after surgery, and 46.7 +/- 19.4 mg compared with 68.6 +/- 38.6 mg forty hours after surgery). Both groups achieved a similar amount of knee flexion on the fifth postoperative day. Over the five-day period after the procedure, the patients in the local analgesia group reported a total of 2.6 +/- 3.9 hours of nausea compared with 7.1 +/- 12.2 hours in the control group. No complications related to the infiltration of the local anesthetic were observed, and all plasma concentrations of the local anesthetic were below the toxic range. CONCLUSIONS: This multimodal perioperative analgesia protocol that included infiltration of a local anesthetic offered improved pain control and minimal side effects to patients undergoing total knee arthroplasty. Our study also confirmed the safety of the protocol.

Analgesia, Patient-Controlled↗
PubMed2004

Intrathecal meperidine decreases shivering during cesarean delivery under spinal anesthesia.

UNLABELLED: Shivering associated with spinal anesthesia is uncomfortable and may interfere with monitoring. We performed this prospective, double-blinded, and randomized study to determine whether intrathecal meperidine (0.2 mg/kg) decreases the incidence and intensity of shivering after spinal anesthesia for cesarean delivery. Forty parturients scheduled for nonemergent cesarean delivery were enrolled in two groups. Spinal anesthesia consisted of hyperbaric bupivacaine (0.75%; 10.5 mg), morphine 0.15 mg, and, in the experimental group, meperidine (0.2 mg/kg) or, in the control group, normal saline. Data collection, including sensory block level, blood pressure, core temperature, and shivering intensity, was performed every minute for 10 min, every 3 min for 33 min, and then every 5 min until the sensory level receded to L4. Time to highest sensory level, maximum number of blocked segments, sensory and motor blockade regression, and systolic blood pressure showed no difference between groups. The incidence of shivering was less (P < 0.02) in the meperidine group, as was its intensity (P < 0.003). Intrathecal meperidine (0.2 mg/kg) is effective in reducing the incidence and intensity of shivering associated with spinal anesthesia for cesarean delivery. IMPLICATIONS: Previous studies have suggested that IV meperidine is helpful for treating intraoperative shivering. This study was undertaken to evaluate spinal meperidine and found that it decreases the incidence and intensity of shivering associated with spinal anesthesia for cesarean delivery.

Adult↗
PubMed2003

Asystolic cardiac arrest: an unusual reaction following iv metoclopramide.

PURPOSE: To describe a case of sinus arrest after iv metoclopramide. CLINICAL FEATURES: A 66-yr-old diabetic female with no cardiovascular disease was anesthetized for a partial mastectomy. While in the postanesthesia care unit, she suffered two episodes of asystole after iv metoclopramide 10 mg. The first episode lasted ten seconds and corrected spontaneously while the second episode, lasting less than one minute required closed chest massage and atropine iv 0.8 mg. The cardiac investigation that followed was inconclusive for ischemia and the patient did not experience any other episodes of dysrhythmia. No formal investigation was done to disclose diabetic autonomic neuropathy. However, based on the results of dipyridamole myocardial single photon emission computed tomography, if diabetic autonomic neuropathy was present, it was very mild. CONCLUSION: The patient sustained two episodes of asystole after iv metoclopramide 10 mg in the immediate postoperative period in the absence of any predisposing cardiac history or medication. Diabetes, even without overt autonomic neuropathy, may have been a predisposing factor for sinus arrest after iv metoclopramide.

Aged↗
PubMedDate not supplied

Study design, originality and overall consistency influence acceptance or rejection of manuscripts submitted to the Journal.

PURPOSE: To identify the characteristics of the manuscripts submitted to the Canadian Journal of Anesthesia (CJA) associated with their acceptance or rejection and to analyze the reviewers' comments and their impact on the editors' decision to publish. METHODS: Peer review material was analyzed from 213 submissions to the CJA. Characteristics of accepted and rejected manuscripts were compared. Reviewers' comments were classified according to editorial criteria used by the journal and the distribution of the different types of comments amongst accepted and rejected submissions was compared. RESULTS: Characteristics of 213 manuscripts and comments from 405 reviewers were analyzed. Overall, 57% of manuscripts submitted to the CJA were accepted. The type of research (study vs case report, clinical vs laboratory science) had no impact on the fate of the manuscripts; however, frequency of acceptance differed between articles originating from different geographic regions (P < 0.0001) with Canadian submissions posting the highest frequency (86%). Comment analysis suggests that the relationship between the experimental design, the results, and the conclusion was the main determinant of an article's fate. Lack of originality or inappropriate experimental design were likely to be associated with rejection. Conversely, aspects involving the presentation of manuscripts (tables, figures, references) were rarely cited as reasons to justify acceptance or rejection. CONCLUSION: Although articles are judged on many criteria, authors need to be aware that some aspects of a manuscript, namely the relationship between experimental design, results, and conclusions, the originality, and the use of an appropriate study design, are the most important features with regard to its acceptance or rejection.

Anesthesiology↗