Changes in metabolism of cerebral glucose after stereotactic leukotomy for refractory obsessive-compulsive disorder: a case report.

Brain glucose metabolism was investigated with PET and [18F]fluorodeoxyglucose, before and after a bifrontal stereotactic leukotomy in a 37 year old woman with refractory obsessive-compulsive disorder. A bilateral decrease in glucose metabolism was found in the orbital frontal cortex after psychosurgery. Glucose metabolism was decreased to a lesser degree in Brodmann's area 25, in the thalamus, and in the caudate nucleus.

The effect of oral ondansetron in the prevention of postoperative nausea and vomiting after major gynaecological surgery performed under general anaesthesia.

The efficacy and safety of ondansetron in preventing postoperative nausea and vomiting following major gynaecological surgery was evaluated in this multicentre, double-blind study. A total of 243 patients were randomised to receive three doses of oral ondansetron 8 mg or matching placebo at 8-hourly intervals, with the first dose being given an hour before surgery. A standard general anaesthetic technique was employed throughout.

Morbidity risk for alcoholism and drug abuse in relatives of cocaine addicts.

The morbidity risks for alcoholism in the first-degree relatives of a cohort of male cocaine addicts with or without alcoholism comorbidity were studied. Of the 71 patients who participated in our study, 40 (56.3%) had a history of alcoholism and 37 (59.

Popliteal sciatic nerve block aided by a nerve stimulator: a reliable technique for foot and ankle surgery.

The reliability of popliteal sciatic nerve blocks was prospectively assessed in 625 blocks performed in 507 patients. The sciatic nerve was approached at the apex of the popliteal fossa, in the midline, with an insulated needle connected to a peripheral nerve stimulator partially designed by one of the authors. When needed, an inguinal paravascular femoral nerve block was also performed.

Latex allergy in a child: report of a case.

A case of life-threatening anaphylactic shock in a boy undergoing complex urologic surgery under combined general and epidural anesthesia is described. Latex allergy was suspected and later confirmed by a positive RAST for latex. A short review about latex allergy, its diagnosis and prevention is presented.

Mortality and morbidity conferences in a teaching anesthesia department.

In our anesthesia department, Morbidity and Mortality conferences (M & M's) evolved from a well established system of voluntary reporting of anesthesia related incidents. They were however not restricted to accidents solely attributable to anesthesia. Between May 1983 and December 1989, 160 cases were presented, usually by the resident or consultant in charge of the patient at the time of event.

Intraoperative hemodynamic modifications during pediatric orthotopic liver transplantation.

OLT is generally associated with important cardiovascular changes occurring during the vascular clamping and at the time of revascularization of the newly transplanted liver. In our series of 60 OLT performed in 52 children, the IVC clamping is generally followed by a fall in the PAP and the PWP, the SBP remaining fairly stable in half of the cases. This good tolerance is confirmed by the fact that a veno-venous bypass was used only in 3 instances and vasopressive drugs were needed in only 6 cases.

Sudden complications in regional anesthesia.

In regional anesthesia sudden and severe complications occur from time to time and may rapidly turn into life threatening situations. Their rarity might well be their most vicious characteristic. Therefore, awareness of the possible complications, careful preparation to cope with them, vigilance enabling prompt recognition of their occurrence and quick administration of the appropriate treatment are all essential for a safe practice of regional anesthesia.

A new lormetazepam galenical formulation for sublingual premedication.

This study reports a double-blind evaluation of a new formulation of lormetazepam for sublingual administration, given as a premedicant in 48 female patients undergoing minor gynecological procedures. Both patient's and nurse's assessments for anxiety and sedation were recorded at different times. Anxiolysis and sedation were present 30 minutes after administration of the drug as reported by the patient with a peak effect at 45 minutes.

The peroperative management in multiple organ donors: a crucial phase in organ transplantation.

Recent developments in organ transplantation led to the fact that any potential cadaver donor might be considered as a multiple organ donor (MOD). The anesthesiologist's role is to maintain good hemodynamic conditions during the long and complex harvesting procedure, taking into account that in renal cadaver transplantation, donor's stable hemodynamic conditions play a crucial role in the immediate function of the graft. Taking the opportunity of a case of simultaneous liver, pancreas and kidneys procurement in the same cadaver donor performed for the first time in our country, we are reviewing the different phases of the donor peroperative management.

Anesthetic protocol in human renal transplantation: twenty-two years of experience.

This paper reviews the experience of 22 years of transplantation. From June 1963 to December 1984, 1362 human renal grafts were performed in our center. Throughout this period, advances in surgical techniques, kidney preservation methods and immunosuppressive regimen have improved patient and graft survival.

Anesthetic experience in adult and pediatric orthotopic liver transplantation.

The authors report their experience with orthotopic liver transplantation in 8 adults and 6 children operated during a 14 months period. The anesthetic technique is described and three points of it are underlined: Renal failure is prevented by a systematic low-dose dopamine infusion added to optimal preloading and mannitol given during the anhepatic phase. Donor liver flush via the portal vein with lactated Ringer's solution is checked by serial measurements of K+ concentration in the fluid draining from the infrahepatic vena cava: the flush is assumed adequate if that K+ level is less than 10 mmoles/l.

Craniofaciosynostosis: anesthetic and perioperative management. Report of 71 operations.

Faciocranial dysmorphisms are at the present time corrected during very complex procedures aiming at functional, esthetic and psychological improvement. The authors present their 9 years experience of 71 operations. The age at which those operations are performed is between 6 and 12 months for 14 patients (20%) and under 6 months for 34 patients (48%), the youngest patient being 6 weeks old.

A safe alternative to awake intubation in neonates.

The authors present a retrospective study on the safety of their induction technique of anaesthesia in infants less than 30 days old. The records of 197 consecutive cases are reviewed, 47 of which concern major cardiac surgery. All the details of the technique are given: inhalation of halothane in O2 following a vagolytic premedication, spray of lidocaine 2 mg/kg on the vocal cords, orotracheal intubation to check adequacy of foreseen tube size, followed by definitive nasal intubation with the tube passed over a siliconed suction catheter.