Biomedical subjects

S Dubos

Publications and source records attributed to S Dubos.

4 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

[Difficult intubations. A prospective study].

A prospective tubing of tracheal tubing in view of general anesthia was performed in 441 adults undergoing scheduled surgery. Before surgery, the anesthesists and ENT specialists tried to independently predict the cases of difficult tubing, according to different criteria. Tubing actually was difficult in 38 patients (8.6ù) instead of the 21 (55.2%) expected by the ENT specialists and/or the anesthesists. These difficulties were solved by bronchoscopy, which allowed tubing to be performed with a guide-probe (3 cas), by scheduled fiberendoscopy (6), tracheotomy (1), nasotracheal tubing (1), spontaneous ventilation (2), and orotracheal tubing in 25 cases. Current knowledge of the predictive criteria is incomplete: anesthesists must be aware of the assistance techniques required in case of difficult tubing in a non-ENT context.

Adult↗

PubMed1990

[Intubation in otorhinolaryngologic surgery: propofol versus propofol-suxamethonium].

This study was carried out to assess the conditions of intubation in head and neck surgery when using propofol alone or associated with suxamethonium. Sixty patients were randomly allocated in two groups of 30. Group I was given 3 mg.kg-1 propofol and Group II 3 mg.kg-1 propofol immediately followed by 1.5 mg.kg-1 suxamethonium. All patients were premedicated orally with midazolam 0.1 mg.kg-1, 0.5 to 1 mg atropine and 7 to 10 micrograms.kg-1 alfentanil, while a colloidal solute (Plasmion) up to 250-500 ml was infused. One minute after injection of propofol, lidocaine 5% was pulverized on the glottis and intubation performed. The mean time required for intubation was similar in both groups: 128 +/- 10 sec in group I vs 132 +/- 9.7 sec in group II. Thirty-five % of patients had to be considered as difficult to intube but the mean times in these cases were not statistically different: 169 +/- 14 sec in group I vs 175 +/- 13 sec in group II. Opening of the glottis was found to be better in group II than in group I (p less than 0.01) and bucking was more frequent in group I (p less than 0.01). Successful intubation was obtained after one attempt at a similar rate in the two groups. The haemodynamic variations consisted in a significant decrease of systolic blood pressure compared to the initial value but these variations were similar in the two groups at each time (2.3 and 5 min) from induction.(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↗