RESUMO
Better understanding of the mechanisms of the development of subacute bacterial endocarditis following stomatological procedures in the patient with heart disease implies the more rational use of prophylactic measures. Preventive antibiotics, often given empirically, decrease the unavoidable bacteremia threshold and hence the threat of endocarditis. After reviewing the risks factors linked with the cardiac problem and with the stomatological procedure, the authors justify the choice of a simple prophylactic protocol, linked both to the microbial types encountered as well as to commonly used effective antibiotics.
Assuntos
Assistência Odontológica/métodos , Endocardite Bacteriana/prevenção & controle , Cardiopatias Congênitas , Cardiopatias , Antibacterianos/uso terapêutico , Assistência Odontológica/efeitos adversos , Endocardite Bacteriana/etiologia , Cardiopatias Congênitas/microbiologia , Cardiopatias/microbiologia , Humanos , Saúde Bucal , Risco , Sepse/microbiologiaRESUMO
The authors emphasize the difficulties encountered with fractures of the zygomatic bone, both from the technical operative points of view and conditions of anaesthesia and intensive care. They distinguish in both fields, the so-called simple zygomatic fractures from fractures associated with multiple injuries of the face or skull. After recalling the surgical techniques, they consider routine management, from diagnosis to recovery from the anaesthetic, emphasizing the problem of the time of the operation, of the method ensuring freedom of the airways and anaesthetic indications used together with problems of intensive care.
Assuntos
Anestesia Geral , Ressuscitação , Fraturas Zigomáticas/etiologia , Fraturas Zigomáticas/cirurgia , Adulto , Anestesiologia , Anestésicos , Emergências , Feminino , Fixação de Fratura , Humanos , Masculino , Traumatismos Maxilofaciais/complicações , Fraturas Zigomáticas/complicações , Fraturas Zigomáticas/patologiaRESUMO
The authors used during 75 prolonged general anaesthesia in maxillo-facial surgery CT. 1341 (Alfatesine) administered pure at constant flow rate through a double lumen venous cannula and electric perfuser. Four series of patients were thus distinguished depending on their use or not of N2O as the only analgesic and of gallamine. We do not agree with the classical assertion that CT. 1341 has a cumulative effect on some EEG results. The technique is quite inocuous and the authors propose a technique using CT. 1341 at a dose of 0.1 ml/kg for induction of anaesthesia with, later, 1 mg/kg of gallamine. Under a mixture of oxygen and nitrous oxide at 60 p. 100, the maintenance dose advised in 6.17 microliters per kilo, per minute of CT. 1341.