[Fatal rifampicin poisoning. Apropos of a case]. / Intoxication mortelle par la rifampicine. A propos d'une observation.

Successful suicide attempts by rifampicin are not commonly reported in literature. Fatal cases and mechanisms of death are most of the time unexplained. We report a suicidal case in a 33-aged man with fatal course occurring 27 hours after acute overdosage with 15 g rifampicin. Criterias of prognostic value are discussed: clinical signs in particular the redman syndrome, and biological data. None of them allows us to prevent fatal issue but, since cardiac arrest of unknown origin may rapidly occur, admission in intensive care must be carried out promptly with a total dose absorbed of 12 g and/or evident clinical signs.

[Prolonged effect of midazolam with delayed postanesthetic recovery from the possible interference of famotidine]. / Effet prolongé du midazolam avec retard de réveil postanesthésique par interférence possible avec la famotidine.

We report the case of a 79-year-old woman, in chronic renal insufficiency who recovered from anaesthesia after a delay of 24 hours, after flumazenil (Anexate) administration. She was given famotidine (Peptidine) the day before surgery. Midazolam was administered for premedication (5 mg per os) and for the induction of anaesthesia (2 mg intravenous). Among the various causes of delayed recovery in this elderly patient, an interaction between midazolam and famotidine is discussed.

Lidocaine plus ropivacaine versus lidocaine plus bupivacaine for peribulbar anesthesia by single medical injection.

UNLABELLED: This study was designed to compare the effects of ropivacaine and bupivacaine, each combined with lidocaine, during peribulbar anesthesia by single medial injection for cataract surgery. One hundred patients were included and randomly divided into two groups of 50, given a mixture of 50% bupivacaine (0.5%) and 50% lidocaine (2%) or 50% ropivacaine (1%) and 50% lidocaine (2%), and 25 U hyaluronidase per mL with each combination. After the first injection, patients given ropivacaine exhibited significantly better akinesia than those given bupivacaine, and significantly fewer were reinjected (19/50 vs 31/50). Among the patients reinjected, peroperative akinesia and analgesia proved satisfactory in both groups. We observed three cases of diplopia caused by retraction of the internal rectus muscle and two cases of moderate ptosis after superonasal reinjection. Hemodynamic profiles were similar in the two groups, and no major side effects were noted during the observation. One percent ropivacaine may be a more appropriate agent than 0.5% bupivacaine for peribulbar anesthesia by single medial injection. IMPLICATIONS: One percent ropivacaine may be a more appropriate agent than 0.5% bupivacaine for peribulbar anesthesia by single medial injection. Combined with lidocaine, it provides better akinesia and similar analgesia.