Biomedical subjects

Y Jullien

Publications and source records attributed to Y Jullien.

4 recordsLinked to original sources

PubMed1979

[Peridural anesthesia and cesarean section. Apropos of 117 cases].

One hundred and seventeen caesarean sections performed under epidural anesthesia are reported. Following localization by air myelography, catheterization of the epidural space was performed in all cases. The estimated level of injection was L 1.76 +/- 0.82. The local anesthetic used was: lignocaine 2 p. 100 with adrenalin 1/160,000 (N = 13) in a dose of 388 mg +/- 81.4; bupivacaine 0.5 p. 100 with adrenalin 1/2000,000 (N = 77) in a dose of 106.6 mg +/- 20; or a mixture of bupivacaine 0.5 p. 100 with adrenalin 1/200,000 and lignocaine 2 p. 100 without adrenalin (N = 27) at doses of 91.0 mg +/- 23.9 and 238 mg +/- 53.4 respectively. The failure rate was 5.97 p. 100 and the operative conditions were satisfactory in 91.5 p. 100 of cases. Apgar scores were greater than 7 in 87 p. 100 of cases at one minute and 99 p. 100 of cases at 5 minutes. The proportion of minor incidents was 30 p. 100, and of complications 3.5 p. 100. Their prevention and treatment and the anesthetic protocol are discussed.

Adolescent↗

PubMed1979

[Postoperative analgesia by constant flow injection of lignocaine in obstetrical and gynecologic surgery].

154 surgical patients were given post-operative analgesia by peridural injection at a constant flow in the post-operative period after obstetric or gynecological surgery. These patients received 536.2 +/- 105.3 mu mol.h-1 (145.2 +/- 28.5 mg.h-1) of lignocaine for 46.97 +/- 15.56 h through a catheter omserted between L1-L2. The drug was given in concentrations which varied between: 27.7 to 18.5 m mol.l-1 (0.75 to 0.50 p. 100) depending on the age; and the volume varied between 17.5 to 30 ml.h-1 depending on the height. Satisfactory analgesia in 87 p. 100 of cases allowed all supplementary analgesia to be stopped. The only significant hemodynamic effect was a slight tachycardia (+ 15 p. 100). Two undesirable side effects were noted: a transitory but well-defined (type 2 or 3) motor paralysis, and an accumulation of plasma lignocaine (40 mu mol.l-1 (1.1 microgram.ml-1) at 48 h).

Analgesia↗

PubMed1979

[Comparison of postoperative blood cortisol levels after neuroleptanalgesia and extradural anesthesia].

Postoperative plasma cortisol levels were measured in two series of surgical patients who had undergone a gynaecological operation, with respectively 17 and 16 subjects. Samples were drawn on D0 6pm, D1 8am, D2 8am and D3 8 am. A reference sample had been taken before the premedication on D0 at 8 am. The first series had been anaesthetised using a dextromoramidedroperidol type neuroleptanalgesia followed by postoperative analgesia by a noramidopyrine compound. The second series required epidural anaesthesia followed by postoperative analgesia by the injection of lidocaine at constant rate, interrupted between the last two samples. In the neuroleptanalgesia group: from a basal level of 470 nmol.l-1, plasma cortisol rose to 800 nmol.l-1 (p less than 0.01) on D0 at 6 pm to subsequently remain on a plateau between 500 and 550 nmol.l-1 (NS) within the normal physiological limits for the laboratory. In the epidural group, from a basal level of 420 nmol.l-1, plasma cortisol rose to 1000 nmol.l-1 (p less than 0.01) to return to basal levels only on D3: 450 nmol.l-1 (NS) with intermediate values of 700 and 630 nmol.l-1 (respectively: p less than 0.001 and p less than 0.05). Statistical comparison between the two groups showed that the increase in cortisol in the epidural group in relation to the other was significant throughout the period of administration of lidocaine at constant flow rate: p less than 0.05 on D0 at 6pm, D1 and D2. The results are discussed.

Adult↗

PubMed1978

[Effects of peridural analgesia on labor].

A review of the effects during labour of epidural analgesia on dilatation, expulsion and delivery of the placenta. Uncertainties in knowledge of the precise organisation of uterine innervation and of the intrinsic innervation of the organ render the study of changes in uterine contraction and in cervical resistances difficult. At circulating levels higher than those found in clinical practice, local anaesthetics have a definite oxytocic e-fect, local anaesthetics have a definite oxytoci effect, whilst adrenalin is a powerfult tocolytic. By contrast, the indirect effects related to neurolysis in extradural analgesia are negligeable. Cervico-segmentary resistances are decreased. In practice, there is no increase in the period of dilatation in the absence of any haemodynamic disturbances and if mixtures containing adrenalin are avoided. Expulsion is favourised by muscular relaxation but impaired by the lack of voluntary expulsive effort, hence the choice of a local anaesthetic with the lowest possible motor effect. Delivery of the placenta, which involves only uterine contraction, which is not affected, may be accelerated by oxytocics.

Anesthesia, Epidural↗