ABSTRACT
We report a case of persisting suprascapular nerve palsy after surgery under general anaesthesia of short duration in a conventional position. Surgical exploration, eight months later, showed a suprascapular notch narrowed by a hypertrophied and calcified superior transverse ligament. Such a lesion and the practice of volley-ball by the patient are in favour of a pre-existing infraclinical neuropathy.
Subject(s)
Brachial Plexus/injuries , Nasal Septum/surgery , Posture , Rhinoplasty/adverse effects , Adult , Anesthesia, General , Athletic Injuries/complications , Athletic Injuries/diagnosis , Calcinosis , Female , Humans , Hypertrophy , Joint Capsule/injuries , Joint Capsule/innervation , Joint Capsule/pathology , Male , Postoperative ComplicationsABSTRACT
A combination of complete left bundle branch block (LBBB) and symmetrical negative T waves on the ECG characterizes the Chattergee syndrome. This pattern is infrequently and fortuitously detected in the absence of clinical symptoms. However, when appearing during general anaesthesia, it may lead to diagnostic difficulties to rule out a myocardial ischaemia. One case of this pattern was observed near the end of an otherwise non-complicated cholecystectomy in a ASA II 45 year old man, ECG abnormalities lasted for only a short time. Recovery and outcome were uneventful. Investigations were negative except for an early LBBB during the exercise test. Echocardiography and coronarography were normal. No therapy was given. In such perioperative cases, it is recommended to keep a very cautious attitude and to search for an incipient coronary disease which cannot be completely excluded in some cases.
Subject(s)
Bundle-Branch Block/etiology , Intraoperative Complications , Bundle-Branch Block/therapy , Cholecystectomy , Diagnosis, Differential , Electrocardiography , Humans , Myocardial Ischemia/diagnosis , SyndromeABSTRACT
The study of pathophysiological and symptomatological characteristics of pain in emergency situations, and of its harmful consequences, shows that, in spite of a difficult context, analgesia is an essential part of the care to patients during the prehospital stage. Its prescription implies a good knowledge of analgesia techniques, including precise rules such as titration. The choice of analgesia must be the outcome of a rigorous step giving priority to the vital functions and associating several techniques. Regional anaesthesia is not very often used in prehospital emergency but rather in emergency units and in the surgical ward. Analgesia must be adapted, mainly to specific situations in emergency: children, old people, burned people with pain.
Subject(s)
Analgesia/methods , Anesthesia, Conduction , Emergencies , Analgesics, Opioid/administration & dosage , Anesthesia, Conduction/methods , Anti-Inflammatory Agents, Non-Steroidal/administration & dosage , Humans , Ketamine/administration & dosage , Midazolam/administration & dosage , Pain/physiopathologyABSTRACT
The authors report their experience of the use of various sources of oxygen feeding in wartime: a classical feeding by liquid oxygen or by extractive oxygen cylinders; a new type of feeding by oxygen condensers or chemical oxygen. According to their practical experience, each source finds its role in wartime, this role being determined by war conditions.
Subject(s)
Oxygen/supply & distribution , Warfare , Drug Packaging , Humans , Hyperbaric Oxygenation/instrumentation , Oxygen/chemistryABSTRACT
Three men (31, 34, 36 yr old) were rescued after they had drifted for 50 hours on their wrecked catamaran. While their apparent clinical condition was not worrying, besides multiple bruises, marked dehydration, epigastralgias, mild hypothermia in one patient and 50, severe biological disorders were present in all four: haemoconcentration, functional renal insufficiency, metabolic acidosis, severe rhabdomyolysis, hepatic cytolysis. After intravenous rehydration for 24 hr hydroelectrolytic and acid-base anomalies were corrected. Pathophysiology of shipwreck casualties is recalled. Initial management in ICU is necessary. Psychological and emotional aspects should not be underrated.
Subject(s)
Liver Diseases/etiology , Near Drowning/complications , Peptic Ulcer/etiology , Rhabdomyolysis/etiology , Water-Electrolyte Imbalance/etiology , Acidosis/metabolism , Adult , Humans , Male , Near Drowning/psychology , Stress, Psychological/complications , Water-Electrolyte Imbalance/therapySubject(s)
Theophylline/poisoning , Aged , Antidotes , Charcoal , Chronic Disease , Drug Overdose , Humans , MaleABSTRACT
The authors report a retrospective study of 500 colonoscopies performed on outpatients under general anaesthesia. Anaesthesia protocol associated diluted propofol in continuous titrated infusion and alfentanil. The doses used were relatively low and no serious adverse effects were observed. Therefore this method appears to be appropriate for most outpatients undergoing a colonoscopy provided that usual security rules are respected.
