Bupivacaine accentuates the cardiovascular depressant effects of verapamil in conscious dogs.

To investigate the potential risk of regional anaesthesia in a verapamil-treated patient, the cardiovascular effects of a combined intravenous infusion of bupivacaine and verapamil were studied in seven conscious and chronically instrumented dogs and were compared to those obtained when each drug was infused separately in the same animals. During verapamil infusion, the decrease in arterial pressure and myocardial contractile force, and the increase in heart rate were constant during the infusion. The lengthening of PR interval correlated with the plasma level of verapamil.

Comparative trial of Hexabrix (320 mg iodine/ml), iohexol (300 mg iodine/ml) and iopamiron (300 mg iodine/ml) in cerebral and spinal angiography: a preliminary report.

A comparison has been carried out of results of cerebral and spinal-cord angiography with two non-ionic contrast media, iohexol and Iopamiron, and a low-osmolality contrast medium, Hexabrix. A comparative study of iohexol, Hexabrix, and Iopamiron was carried out in a first group of 41 patients, and Hexabrix was compared with Iopamiron in a second group of 56. Evaluation criteria included local and general safety, as well as quality of angioscopy and angiography.

Effects of lidocaine on myocardial contractility and baroreflex control of heart rate in conscious dogs.

The effects of intravenous lidocaine (30 and 60 micrograms X kg-1 X min-1 during 30 min) at steady-state plasma levels (1.9 +/- 0.2 and 3.

[French survey on anesthesia systems and peroperative respiratory monitoring equipment].

A national inquiry has been carried out in France. It concerned the anaesthetic systems and respiratory monitoring equipment in use at the moment, as well as that wished for. The equipment in use was very stereotyped: an open system with a respirator, for the most volumetric, and with a safety O2/N2O mixer.

Ventilatory response to CO2 following axillary blockade with bupivacaine.

The systemic effect of bupivacaine on the control of ventilation was studied in eight ASA I (six male, two female) unpremedicated healthy subjects aged 30-55 yr (mean 43.5 yr) and weighing 59-82 kg (mean 69 kg) after axillary blockade with bupivacaine 0.5% without epinephrine, 3 mg/kg.

[Primary-purpose peridural analgesia in labor induction].

21 parturients, showing in most of cases either high blood pressure badly controlled or a "real" out of date term, have undergone a peridural analgesia of first intention in labour induction. All these patients were considered to be uninducable according to Bishop score. After an injection of adrenalinized bupivacaïne, either 0.

Antidiuretic hormone response to osmotic stimulus under fentanyl anaesthesia.

The effect of fentanyl anaesthesia on the plasma antidiuretic hormone (ADH) response to osmotic stimulus was studied in eight patients. Eight g (137 mmol) NaCl were rapidly injected intravenously the day before anaesthesia and blood samples were collected 5, 10, 20 and 30 min after the injection. This protocol was repeated in the same subjects, under anaesthesia with thiopental, nitrous oxide and fentanyl before surgical incision.

[Transcutaneous cerebral electric stimulation by Limoge current during labor].

In order to test the analgesic efficacy of Anesthelec (transcutaneous cranial electrical stimulation with Limoge currents) during labour and delivery, a double blind study was performed in 20 cases for whom analgesia was necessary. In 10 cases Anesthelec was used with the Limoge currents on and in 10 cases as a sham. Labour and delivery were carried out by a medical team different from that which set up the Anesthelec.

Diaphragm dysfunction induced by upper abdominal surgery. Role of postoperative pain.

The effects of upper abdominal surgery on diaphragmatic function were studied in 5 patients. During quiet tidal breathing, the volume displacement of the abdomen within the tidal volume (Vab/Vt) and the ratio of abdominal and transdiaphragmatic pressure changes (delta Pab/delta Pdi), taken as an index of the diaphragmatic contribution to the breathing process, decreased significantly on the first postoperative day (p less than 0.001); in 2 patients, a cephalad paradoxical motion of the diaphragm during inspiration was observed.

Effect of analgesia on respiratory muscle function after upper abdominal surgery.

The effects of three methods of analgesia (intravenous morphine, epidural lidocaine and epidural morphine) on vital capacity (VC), forced expiratory volume in 1 s (FEV1) and maximal expiratory and inspiratory pressures (MEP and MIP) at the mouth were studied in 12 high respiratory risk patients following upper abdominal surgery. VC, FEV1, MEP and MIP markedly decreased following laparotomy. VC and FEV1, were partially restored by epidural analgesia and remained unchanged following intravenous morphine.

[Post-operative respiratory function after subcutaneous and epidural morphine analgesia (author's transl)].

In 20 elderly patients who underwent cholecystectomy post-operative analgesia was obtained with morphine given either subcutaneously (n = 10) or epidurally (n = 10). Both groups were comparable as to age and pre-operative respiratory function values. On the first post-operative day, vital capacity, forced expiratory volume in one second and and paO2 were significantly higher in the epidural morphine group (respectively 70 +/- 6 p.

[Prevention of anesthesia accidents].

All general anesthetics include a risk to life. The etiology and circumstances of complications with cardiac arrest are studied. Accent is placed on the frequency of fatal accidents for benign operations and on the poor prognosis of accidents with hypoxia.

[Extraction of intrabronchial foreign bodies in young patients in a surgical unit].

The authors report a study of 35 cases of intra-bronchial foreign bodies in young subjects (average age 6 years). This shows that, more than the age of the child, or the duration of the presence of the object, its nature, has an influence on the possibilities of extraction by bronchoscopy or by thoracotomy. Whatever the nature of the foreign body, the authors emphasize the importance of the quality of the team formed by the endoscopist and the anaesthetist, repeated attempts at bronchoscopy compromise success and may lead to tracheotomy.

[Tracheobronchial ruptures seen in emergencies. Viewpoint of the anesthesiologist].

At the Marie Lannelongue surgical centre between 1964 and 1975, out of 278 patients with trauma of the thorax, we noted only 10 cases of tracheal-bronchial rupture admitted as an emergency = 9 ruptures due to closed trauma of the thorax, one with division of the lower part of the trachea. Analysis of these cases showed in particular:-the notion of violent trauma in -young subjects (average age: 20 years). In these thoracic injuries suspected of tracheal-bronchial rupture, the anaesthetist intervenes in four early stages: 1) arrival of the injured patient 2) bronchoscopy-diagnosis 3) surgical operation, the anaesthetic problems are linked to various factors, the most important of which are the very precarious cardio-respiratory condition, the lack of information and, sometimes, the lack of time.