[Endotracheal tube for laryngeal CO2 laser microsurgery. 208 cases]. / Sonde d'intubation pour la microchirurgie laryngée par laser CO2. 208 observations.

To suppress the risk inherent in laryngeal microsurgery performed with a CO2 laser beam, the authors suggest to use a reinforced silicone endotracheal tube, the cuff of which is protected by a silicone plus aluminium powder shield. The resistance of silicone to fire is augmented during laser shots by a nitrogen flow on the upper side of the shield at the rates of 2 l/min in patients breathing air and 30 l/min in patients give oxygen.

[Amnesic effect of nitrous oxide in gradual general anesthesia]. / Effet amnésiant du protoxyde d'azote au cours de l'anesthésie générale graduelle.

PIP: The amnesic effect of nitrous oxide was studied in 50 women undergoing induced abortions under general anesthesia at a hospital in France. The request for general anesthesia was made by the practitioner, by psychologists working with the women, or by the women themselves. Patient ages ranged from 13-39 years and averaged 24. All patients were given 1 mg of dextromoramide. During the procedure a mixture of 50% nitrous oxide and 50% oxygen was delivered. The patient was asked to count to 200 and remember a list of 5 words, and questions were posed. The nitrous oxide was terminated at completion of the aspiration. Awakening occurred in under 5 minutes with nitrous oxide and oxygen and at around 10 minutes when halothane was added. 30 minutes after awakening the patient was questioned about the surgery and the preoperative talk and questions. None of the patients recalled insertion of the speculum. In 46 of the 50 cases a total or partial amnesia occurred. Among 20 patients given the nitrous oxide-oxygen mixture only, 15 experienced total, 4 partial, and 1 no amnesia. Among the 30 patients given the same gas mixture and halothane, 25 experienced total, 2 partial, and 3 no amnesia. Nitrous oxide has no effect on longterm memory and probably inhibits the 1st phase of memorization. There are several components of its mode of action: classic analgesia, a potentializing effect with morphinomimetics and other general anesthesias, and an amnesia of painful and disagreeable interventions.^ieng

[Cardio-circulatory monitoring. Special protection in operating room (author's transl)]. / Monitorage cardio-circulatoire en salle d'opération. Conditions particulières.

Authors who organised the 3e Réunion Inter-Régionale Nord d'Anesthésiologie sur le thème "Practice of Monitoring in Anesthesia and in critical care" proposed the creation of an incidents recorder for increasing patients' safety and medico-legal protection of Anesthesiologists.

[Danger or security of spontaneous apnea in relation with previous ventilation (author's transl)]. / Danger ou sécurité de l'apnée volontaire en fonction du mode de ventilation préalable.

Using a spectrometer for the study of exhaled gases and a monitor of transcutaneous oxygen pressure, our purpose has been to quantify our ideas about physiological apneas in the conscious voluntary adults. We compared the apneas, concerning the duration and the induced fall of peripheric oxygen pressure, after normoventilations in air and in oxygen, then after hyperventilations in air and in oxygen. These experiences confirm the tiny interest of previous normoventilation in oxygen compared with in air, the danger of hypoxemia by previous hyperventilation in air and the possibility of prolonged but safe apnea after hyperventilations in oxygen, that we can advocate in the induction of anaesthesia for some circumstances.

[Organization of first aid on the northern motorway in Picardy. Role of the regional Medical First Aid Unit]. / L'organisation des secours sur l'autoroute du nord en Picardie. Rôle du S.A.M.U. régional

The Picardy regional S.A.M.U. implanted in Amiens, has participated in the implantation of antennae of the S.M.U.R. whereby aid can be given accident cases on the northern motorway. After a brief historical review of the creation of these antennae, and presentation of what exists in the sections of the northern motorway not in Picardy, the means of the regional S.A.M.U. are presented, and the way it which it functions, with regards to specific problems concerning medical aid on the motorway. The results of the S.M.U.R. activities are presented and discussed. The necessity for good coordination of medical aid, the fundamental role of the regional S.A.M.U., is particularly emphasized.

[Use of head tent for anesthesia of children (author's transl)]. / Intérêt de la tente de tête en anesthésie pédiatrique. Induction et anesthésie de courte durée.

The authors relate their experience of 61 inhalation anesthesia of children from 5 months to 15 years years old. Head-tent is usually employed for intensive care as a method to administrate pure oxygen. Children are often afraid of the face-mask and tolerate head-tent easier. Three different protocols were studied: Nitrous oxide and oxygen mixture at different level (50 p. cent oxygen, 50 p. cent nitrous-oxide; or 30 p. cent oxygen, 70 p. cent nitrous oxide). The authors also used halothan in the inhalated mixture. The rebreathing level of CO2 in the head-tent according to the gas flow was measured. No incident, nor accident are related. This new anesthetic apparatus is easy to use, well accepted by children.

[The advantages and disadvantages of different methods of access to the internal jugular veins (author's transl)]. / Avantages et inconvénients des voies d'abord veineuses jugulaires internes.

The authors have made a critical study of the respective advantages and disadvantages of the various methods of access to the internal jugular vein. These have been classified under 3 headings: frontal access, lateral access and rear access. They outline their experience of the technique described by Boulanger and Delva in 1977. This method of access seems to be favoured on two scores, its simplicity and the absence of immediate serious complications. These encouraging results lead them to advocate this as the technique they would choose especially in urgent cases.

[Clark's head tent or "small mask"? Value of high oxygen flows administered through a mask]. / Tente de Clark ou "petit masque"? Intérêt des forts débits d'oxygène pur administré au masque.

The measurement of transcutaneous PtcO2 in eight normal adults prove a comparable efficacy of 50 l.min-1 O2 through facial "small mask" (61.5 kPa; 463 mmHg) and 20 l.min-1 O2 through head tent (65.1 kPa; 490 mmHg). First procedure, inexpensive, is very simple to use.

[Seeking an ideal protocol for the stability of blood gases during general anesthesia for bronchosopies]. / A la recherche d'un protocole idéal pour la stabilité des gaz du sang au cours des anesthésies générales pour bronchoscopies

During general anesthesia for bronchoscopy, hypoxemia is a major risk, especially in patients with a severe intrapulmonary shunt. With the technique of apnea in pure oxygen, after one hour denitrogentation, and with an intake of 50 liters of oxygen per minute through the bronchoscope, the PaO2 was greater than 400 mm of Hg, but hypercapnia and acidosis occurred. To compensate the latter, five minute sessions of apnea, alternating with two minutes of jet hyperventilation, nevertheless, have the disadvantage of producing a Ventrui phenomena at the proximal end of the bronchoscope, hence a fall in FiO2 which was dangerous in these high risk patients. The authors propose a method so that the Venturi phenomenon, which cannot be prevented, occurs in pure oxygen.

[CT 1341 in continuous administration in 75 cases of prolonged general anesthesia in odontostomatology (constant flow assured by a double-lumen venous catheter and electric perfuser)]. / Etude du CT 1341 en administration continue dans 75 cas d'anesthésie générale prolongée en odontostomatologie (débit constant assuré par canule veineuse à double lumière et perfuseur électrique

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.

[Rectal anaesthesia with diazepam added to ketamine for preschool child (author's transl)]. / L'association kétamine-diazépam par voie rectale en anesthésie pédiatrique.

The authors relate their experience of 61 rectal anesthesias with ketamine (10 mg/kg) and diazepam (0.25-0.5 mg/kg). Rectal anesthesia is well accepted by children who are afraid of percutaneous injection. When ketamine is used alone, they obtained only 76 p. cent good result. When diazepam is associated, good results arise to 95 p. cent. Diazepam added to ketamine allows surface surgery during 10 to 15 minutes.

[Trans-cerebral electric analgesia: reality, hypothesis or placebo? (author's transl)]. / Electro-analgésie transcérébrale: réalité, hypothèse ou placebo?

Sixty patients undergoing major digestive surgery received the same amount of drugs for induction of anesthesia; neuroleptic, morphinomimetic and pachycurares were used and calculated in mg/kg. A randomisation list permitted to define 45 patients who received in double blind (by means of a long electrical cord), an electrical current varying for each protocol; the control group (15 patients) did not receive an electrical current. Statistical study of the amount of drugs used for follow of anesthesia shows no real effect of electrical analgesia for digestive surgery.