[Adverse effects of neosynephrine]. / Les incidents de la Néosynéphrine.

Phenylephrine is widely used to obtain a sympathomimetic mydriaticum, however eye drops may be followed by a certain number of adverse effects notably cardio-vascular as our observation shows, but also allergic effects, irian pigment liberation in the anterior chamber and iatrogenic corneal oedema.

[Pheochromocytoma in Von Hippel Lindau disease. Apropos of a case of per-operative presentation]. / Le phéochromocytome dans la maladie de Von Hippel Lindau. A propos d'un cas de révélation per-opératoire.

A case of Von Hippel Lindau disease with bilateral pheochromocytoma is reported. The diagnosis of pheochromocytoma is evoked after complications during general anaesthesia for treatment of retinal hemangioblastoma.

[Comparative trial of propofol and ketamine in anesthesia for the baths of severely burnt patients]. / Essai comparatif du propofol et de la kétamine au cours de l'anesthésie pour bain des grands brûlés.

Ketamine was the normal anaesthetic drug for carrying out the baths of severely burnt patients. It was compared with propofol in a study of 50 patients (greater than 50 UBS) randomly assigned to two groups: 2.5 mg . kg-1 propofol and 2 mg . kg-1 ketamine. The speed of induction was the same for both groups, surgery beginning within the same time intervals. In the propofol group, however, apnoea was seen more often and lasted longer (p less than 0.05) than in the ketamine group. The times between repeat injections were short (about 5 min) and constant with propofol, whereas they were larger and irregular with ketamine; this was due to the shorter distribution half-life and lack of accumulation of propofol. During anaesthesia with propofol, haemodynamic parameters remained steady after an initial period of cardiovascular depression. Respiratory rate increased, because of the lack of analgesia. Recovery was very quick, complete and with no bothersome adverse effects in the propofol group. These hypercatabolic patients could therefore be fed early postoperatively; also, there was no deleterious psychological interference in these deeply disturbed patients.

[Course of plasma fibronectin in burn patients. Its variations during septic episodes]. / Evolution de la fibronectine plasmatique chez le brûlé. Ses variations lors d'épisodes septiques.

The time course of plasma fibronectin (FNp) was evaluated following burn injury in 62 patients during 30 days. Those patients were divided into three groups: A: 36 non septic survivors, B: 7 septic survivors, C: 19 dead patients. Those groups were statistically different if either age or total body surface area burnt (TBSA), or unit burnt standard (UBS) or the percentage or third degree burnt area were considered. The relationship between FNp, UBS or sepsis was studied. No correlation was found between FNp levels and TBSA or UBS for the first three days. After acute depletion on day 2, the FNp level returned to initial values on day 3. That depletion was probably a consequence of resuscitation since both falls in plasma FNp and haematocrit were parallel from day 1 to day 2. When the patients became septic, there was always a drop in FNp level. The depleted level of FNp remained low in the patients who finally died, whereas in those who survived that level had returned to normal. The observation of FNp level could therefore be useful in determining how serious a sepsis is.

[Influence of low concentrations of halogenated anesthetics on the electroretinogram and visual evoked potentials in children]. / Influence des anesthésiques halogénés à faible concentration sur l'électrorétinogramme et les potentiels évoqués visuels chez l'enfant.

During anaesthesia for neurophysiological investigations, halogen anaesthetics delivered at high concentrations altered visually evoked potentials. Low concentrations of volatile anaesthetics were proposed to avoid these alterations. Thirty young children, with visual or neurological abnormalities, were divided in two groups: the first group (n = 16), mean age of 20 months, was anaesthetized with halothane 0.5%, and the second (n = 14), mean age of 14 months, with enflurane 1.5%. Retinal action potentials (RAP) and visually evoked potentials (VEP) were obtained by computerized methods. The morphology of graphs before anaesthesia and after increasing concentrations of anaesthetics were compared. Height and latencies of the principal waves were measured. Low concentrations of halothane as well as enflurane avoided RAP and VEP disturbances. Nevertheless, no statistically significant data was obtained because of individual variations due to age, pathology and technical conditions.