A5026213112- Cardiac, Anesthesia and Surgical Outcomes
- Enhanced Recovery After Surgery
- Anesthesia and Pain Management
- Thermal Regulation in Medicine
- Aortic aneurysm repair treatments
- Anesthesia and Sedative Agents
- Ovarian cancer diagnosis and treatment
- Hemodynamic Monitoring and Therapy
- Aortic Disease and Treatment Approaches
- Thermoregulation and physiological responses
- Pain Mechanisms and Treatments
- Climate Change and Health Impacts
- Colorectal Cancer Surgical Treatments
- Respiratory Support and Mechanisms
- Health, Medicine and Society
- Cardiac Arrest and Resuscitation
- Nausea and vomiting management
- Healthcare Systems and Practices
- Nutrition and Health in Aging
- Intraperitoneal and Appendiceal Malignancies
- Vascular Procedures and Complications
- Peripheral Artery Disease Management
- Treatment of Major Depression
- Pain Management and Opioid Use
- Abdominal Surgery and Complications
Hôpital Paris Saint-Joseph
2015-2024
Université Paris Cité
2005-2022
Hôpital Saint Joseph
2015-2022
Saint Joseph University
2022
IQVIA (France)
2021
Centre Hospitalier Saint-Joseph Saint-Luc
2019
Centre Hospitalier Universitaire de Clermont-Ferrand
2018
Inserm
2014-2015
Hôpital Ambroise-Paré
2000-2015
Hôpital Cochin
2014-2015
Background Rapid development of acute opioid tolerance is well established in animals and more likely to occur with large doses short-acting drugs. The authors therefore tested the hypothesis that intraoperative remifentanil administration results manifested by increased postoperative pain requirement. Methods Fifty adult patients undergoing major abdominal surgery were randomly assigned two anesthetic regimens: (1) desflurane was kept constant at 0.5 minimum alveolar concentrations a...
Perioperative bleeding is common in patients undergoing noncardiac surgery. Tranexamic acid an antifibrinolytic drug that may safely decrease such bleeding. We conducted a trial involving Patients were randomly assigned to receive tranexamic (1-g intravenous bolus) or placebo at the start and end of surgery (reported here) and, with use partial factorial design, hypotension-avoidance hypertension-avoidance strategy (not reported here). The primary efficacy outcome was life-threatening...
In Brief Opioids alone sometimes provide insufficient postoperative analgesia. Coadministration of drugs may reduce opioid use and improve efficacy. We therefore tested the hypothesis that administration ketamine or nefopam to patients with pain only partly alleviated by morphine reduces amount subsequent necessary produce adequate Patients (n = 77) recovering from major surgery were given up 9 mg IV morphine. Those who still had randomly assigned blinded 1) isotonic saline (control group; n...
BACKGROUND. Meperidine (pethidine) reportedly treats postoperative shivering better than equianalgesic doses of other mu-receptor agonists. The authors' first goal was to develop a method accurately determine thresholds, and then the extent which meperidine sufentanil inhibit shivering.A computer-controlled infusion started before operation in 30 patients, with target plasma concentrations 0.15, 0.30, or 0.60 microg/ml 0.1, 0.2 ng/ ml targeted; patients were randomly assigned each drug...
The analgesic nefopam does not compromise ventilation, is minimally sedating, and effective as a treatment for postoperative shivering. authors evaluated the effects of on major thermoregulatory responses in humans: sweating, vasoconstriction, shivering.Nine volunteers were studied three randomly assigned days: (1) control (saline), (2) at target plasma concentration 35 ng/ml (low dose), (3) 70 (high dose, approximately 20 mg total). Each day, skin core temperatures increased to provoke...
Background Despite the availability of effective warming systems, prevalence hypothermia remains high in patients undergoing surgery. Occurrence perioperative may influence rate postoperative complications. Recommendations for prevention inadvertent have been developed and are to reduce frequency when professionals comply with. French Society Anesthesiology (SFAR) decided promote guidelines hypothermia, conduct beforehand a pragmatic assessment France. The hypothesis was that hypothermic...
In Brief The effect of laparoscopy on cardiac function is controversial. We hypothesized that dysfunction related to increased afterload could be predominant in patients undergoing elective abdominal aortic repair. To test this hypothesis, we conducted a transesophageal echocardiographic study 15 during laparoscopic surgery. systematically assessed left ventricular (LV) and right (RV) functions. Measurements were obtained the supine position without pneumoperitoneum with an intraabdominal...
Abstract Background For patients undergoing noncardiac surgery, bleeding and hypotension are frequent associated with increased mortality cardiovascular complications. Tranexamic acid (TXA) is an antifibrinolytic agent the potential to reduce surgical bleeding; however, there uncertainty about its efficacy safety in surgery. Although usual perioperative care commonly consistent a hypertension-avoidance strategy (i.e., most continue their antihypertensive medications throughout period...
Summary Pethidine is reported to be more effective than equi‐analgesic doses of other opioids as an inhibitor postanaesthetic shivering. The aim this study was verify whether action resulted from a local anaesthetic effect pethidine or inadequate fentanyl dosage in previous studies. We studied 52 ASA 1 2 patients. They were randomly allocated, double ‐blind fashion, one four groups receive either (0.85 mg.kg ‐1 ) (1.7 μg.kg lignocaine (1 0.9% saline. All the patients shivering and had core...
Summary Cutaneous warming is reportedly an effective treatment for shivering during epidural and after general anaesthesia. We quantified the efficacy of cutaneous as a shivering. Unwarmed surgical patients (final intra‐operative core temperatures ∼ 35 °C) were randomly assigned to be covered with blanket ( n = 9) or full‐body forced‐air cover 9). Shivering was evaluated clinically by oxygen consumption. Forced‐air heating increased mean‐skin temperature (mean (SD) 35.7 °C (0.4) vs. 33.2...
The analgesia and the frequency severity of oxyhemoglobin desaturation related to alfentanil administration were compared in 32 patients randomly selected receive patient-controlled (PCA) by either epidural (EPI) or intravenous (IV) route for a mean period 16 h after major abdominal surgery. Bolus increments 250 μg with lockout interval 5 min IV 10 EPI administered programmable pump. Oxygen saturation (SPO2) was monitored h, using pulse oximeter; data collected continuously stored every 30 s...
The simultaneous application of innocuous cutaneous warm and cold stimuli with a thermal grill can induce both paradoxical pain warmth (heat). goal this study was to investigate further the relationships between these sensations. Stimuli were applied palms right hands 21 volunteers thermode consisting 6 bars, temperature which controlled by Peltier elements. We assessed quality intensity sensations evoked series progressively colder temperatures combined given temperatures. total 116...
Induction of therapeutic hypothermia is often complicated by shivering. Nefopam reduces the shivering threshold with minimal side effects. Consequently, nefopam an attractive component for induction hypothermia. However, alone insufficient; it will thus need to be combined another drug. Clonidine and alfentanil each reduce threshold. This study, therefore, tested hypothesis that nefopam, either clonidine or alfentanil, synergistically threshold.For combination, ten volunteers were studied on...