References of "Bonhomme, Vincent"
     in
Bookmark and Share    
Full Text
Peer Reviewed
See detailCombined use of Bispectral Index (TM) and A-Line (TM) Autoregressive Index (TM) to assess anti-nociceptive component of balanced anaesthesia during lumbar arthrodesis
Bonhomme, Vincent ULg; Llabres, V.; Dewandre, Pierre-Yves et al

in British Journal of Anaesthesia (2006), 96(3), 353-360

BACKGROUND: This study evaluated the A-Line Autoregressive Index (AAI) response to surgical stimulation during lumbar arthrodesis, as an estimate of the anti-nociceptive component of a Bispectral Index ... [more ▼]

BACKGROUND: This study evaluated the A-Line Autoregressive Index (AAI) response to surgical stimulation during lumbar arthrodesis, as an estimate of the anti-nociceptive component of a Bispectral Index (BIS) guided anaesthesia combined with epidural analgesia. METHODS: An epidural catheter was inserted in 23 patients allocated randomly to receive ropivacaine plus clonidine (Group R) or normal saline (Group S) epidurally. General anaesthesia was induced with propofol, cis-atracurium and a remifentanil infusion that was stopped 3 min after tracheal intubation, and maintained using sevoflurane to keep BIS at 50 (range 40-60). Mean arterial pressure, heart rate, end-tidal sevoflurane, BIS and AAI were analysed from 2 min before to 17 min after surgical incision. RESULTS: While BIS was maintained at 50, AAI significantly increased from a 2 min averaged value of 12 (4) to 21 (7) in Group S within the first 5 min after surgical incision, but did not change in Group R. Maximum AAI values reached during the study period were significantly higher in Group S than in Group R [38 (12) and 27 (10), respectively]. Binary logistic regression analysis allowed the calculation of AAI threshold values above which the probability of predominant nociception over anti-nociception was higher than 95%. At 1 MAC sevoflurane concentration, a 2 min averaged AAI of 35 or an AAI peak value of 62 were associated with such a probability. CONCLUSIONS: During a BIS-guided constant level of hypnosis, AAI response to the onset of surgical stimulation significantly differs according to the analgesic regimen. Further studies are needed to refine the estimation of sensitivity and specificity of this variable in assessing the balance between nociception and anti-nociception during general anaesthesia. [less ▲]

Detailed reference viewed: 27 (5 ULg)
Full Text
Peer Reviewed
See detailHead Trauma
Bonhomme, Vincent ULg; Hans, Pol ULg; Brichant, Jean-François ULg

in Acta Anaesthesiologica Belgica (2006), 57(3), 239-47

this review is to provide the reader with the most commonly accepted principles for the management of head trauma patients. The initial clinical evaluation and resuscitation, radiological evaluation ... [more ▼]

this review is to provide the reader with the most commonly accepted principles for the management of head trauma patients. The initial clinical evaluation and resuscitation, radiological evaluation, monitoring, intracranial pressure and cerebral perfusion pressure management, brain protection, associated organ dysfunctions and complications, anaesthetic manage ment and the singularities of paediatric head trauma patients are described, either for the acute phase and the secondary phase of management. [less ▲]

Detailed reference viewed: 41 (26 ULg)
Full Text
Peer Reviewed
See detailComparative effects of ketamine on Bispectral Index and spectral entropy of the electroencephalogram under sevoflurane anaesthesia
Hans, Pol ULg; Dewandre, Pierre-Yves; Brichant, Jean-François ULg et al

in British Journal of Anaesthesia (2005), 94(3), 336-340

BACKGROUND: The Bispectral Index (BIS) and spectral entropy of the electroencephalogram can be used to assess the depth of hypnosis. Ketamine is known to increase BIS in anaesthetized patients and may ... [more ▼]

BACKGROUND: The Bispectral Index (BIS) and spectral entropy of the electroencephalogram can be used to assess the depth of hypnosis. Ketamine is known to increase BIS in anaesthetized patients and may confound that index as a guide to steer administration of hypnotics. We compared the effects of ketamine on BIS, response entropy (RE) and state entropy (SE) during surgery under sevoflurane anaesthesia. METHODS: Twenty-two women undergoing gynaecological surgery were enrolled in this double-blind, randomized study. Anaesthesia was induced i.v. and maintained with sevoflurane. Under stable surgical and anaesthetic conditions, patients were assigned to receive either a bolus of ketamine 0.5 mg kg(-1) or the same volume of saline. Blood pressure, heart rate, BIS, RE and SE were measured every 2.5 min from 10 min before (baseline) until 15 min after ketamine or saline administration. The maximum relative increase in BIS, RE and SE compared with baseline was calculated for each patient. Values are mean (sd). RESULTS: Baseline values were BIS 33 (4), RE 31 (5), SE 30 (5) for the ketamine patients and BIS 35 (3), RE 33 (5) and SE 32 (6) for the patients receiving saline. BIS, RE and SE increased significantly from 5 min (BIS) and 2.5 min (RE and SE) after ketamine administration, peaking at 46 (8) (BIS), 52 (12) (RE) and 50 (12) (SE) respectively. The maximum relative increase in RE [42.2 (10.4%)] and SE [41.6 (10.9)%] was higher than that of BIS [29.4 (10.4%)]. Blood pressure, heart rate and RE-SE gradient did not change in either group. CONCLUSIONS: Ketamine administered under sevoflurane anaesthesia causes a significant increase in BIS, RE and SE without modification of the RE-SE gradient. This increase is paradoxical in that it is associated with a deepening level of hypnosis. [less ▲]

Detailed reference viewed: 37 (4 ULg)
Full Text
Peer Reviewed
See detailThe Cervical Spine in Trauma: Implications for the Anaesthesiologist
Bonhomme, Vincent ULg; Hartstein, Gary ULg; Hans, Pol ULg

in Acta Anaesthesiologica Belgica (2005), 56(4), 405-11

In this paper, the authors review the most recent literature concerning the management of the cervical spine in trauma patients. They address the main topics of concern for the anaesthesiologist including ... [more ▼]

In this paper, the authors review the most recent literature concerning the management of the cervical spine in trauma patients. They address the main topics of concern for the anaesthesiologist including pre-hospital care, clearance of the cervical spine, neuroprotective therapies, difficult tracheal intubation, and management during general anaesthesia, in the intensive care unit and in paediatric patients. The most widely accepted strategies are provided as well as alternative options. [less ▲]

Detailed reference viewed: 5 (1 ULg)
Full Text
Peer Reviewed
See detailEffects of Nitrous Oxide on Spectral Entropy of the Eeg During Surgery under Balanced Anaesthesia with Sufentanil and Sevoflurane
Hans, Pol ULg; Dewandre, Pierre-Yves; Brichant, Jean-François ULg et al

in Acta Anaesthesiologica Belgica (2005), 56(1), 37-43

BACKGROUND: Spectral entropy of the electroencephalogram (EEG) has been proposed to monitor anaesthetic depth. We investigated the effect of nitrous oxide on response (RE) and state entropy (SE) of the ... [more ▼]

BACKGROUND: Spectral entropy of the electroencephalogram (EEG) has been proposed to monitor anaesthetic depth. We investigated the effect of nitrous oxide on response (RE) and state entropy (SE) of the EEG during lumbar disc surgery under anaesthesia with sufentanil and sevoflurane. METHODS: In an open study, anaesthesia was induced with propofol and sufentanil, and maintained with 2% end-tidal sevoflurane concentration in air/oxygen (FiO2 = 0.4) in 25 patients. During surgery, nitrous oxide was randomly administered either at 0 or at 60% end-tidal concentration in 10 (control group) and 15 patients (nitrous oxide group), respectively. RE and SE were recorded at 2.5 min intervals for 10 min before randomization and for 25 min either continuously (control) or after achieving the target nitrous oxide concentration. RESULTS: Two patients who received nitrous oxide were excluded from statistical analysis because of protocol violation. Nitrous oxide provoked a significant decrease in RE and SE from 46.2 +/- 11.1 and 44.3 +/- 11.1 to a lowest value of 27.8 +/- 8.3 and 27.1 +/- 8.9, respectively. The decrease in entropy persisted during the 25 min recording period. CONCLUSIONS: Addition of nitrous oxide during balanced anaesthesia with sufentanil and sevoflurane provokes a decrease in response and state entropy of the EEG during lumbar disc surgery. [less ▲]

Detailed reference viewed: 99 (6 ULg)
Full Text
Peer Reviewed
See detailPropofol scavenges reactive oxygen species and inhibits the protein nitration induced by activated polymorphonuclear neutrophils
Thiry, J. C.; Hans, Pol ULg; Deby-Dupont, G. et al

in European Journal of Pharmacology (2004), 499(1-2), 29-33

Activated polymorphonuclear neutrophils may damage tissues through the release of biochemical mediators. Among them, peroxynitrite is responsible for hydroxylation reactions and nitration of proteins, or ... [more ▼]

Activated polymorphonuclear neutrophils may damage tissues through the release of biochemical mediators. Among them, peroxynitrite is responsible for hydroxylation reactions and nitration of proteins, or is metabolised into nitrate. We investigated the effect of propofol on the production of reactive oxygen species, the nitration of proteins and the formation of nitrate by activated human polymorphonuclear neutrophils. Propofol dose-dependently inhibited chemiluminescence, nitration of proteins and nitrate production in a concentration range from 10(-3) to 10(-6) mM. A significant correlation was observed between the logarithm of propofol concentration and the intensity of chemiluminescence (r(2) = 0.90), the nitration of proteins (r(2) = 0.67) and the production of nitrate (r(2) = 0.79). Those results are consistent with the scavenging effect of propofol on peroxynitrite and could confer a protective property to propofol in pathological situations involving polymorphonuclear neutrophils activation. (C) 2004 Elsevier B.V. All rights reserved. [less ▲]

Detailed reference viewed: 25 (10 ULg)
Full Text
Peer Reviewed
See detailRecovery from Neuromuscular Block after an Intubation Dose of Cisatracurium and Rocuronium in Lumbar Disc Surgery
Hans, Pol ULg; Welter, Philippe ULg; Dewandre, Pierre-Yves et al

in Acta Anaesthesiologica Belgica (2004), 55(2), 129-33

BACKGROUND AND OBJECTIVE: Residual muscle paralysis remains a concern for anaesthesiologists. This study investigated the recovery from neuromuscular block (NMB) after an intubation dose of cisatracurium ... [more ▼]

BACKGROUND AND OBJECTIVE: Residual muscle paralysis remains a concern for anaesthesiologists. This study investigated the recovery from neuromuscular block (NMB) after an intubation dose of cisatracurium (C) or rocuronium (R) in 32 patients undergoing lumbar disc surgery. METHODS: Anaesthesia was induced with propofol and sufentanil, and maintained with sevoflurane in nitrous oxide/oxygen. Patients were randomised to receive twice the ED95 of either cisatracurium (GC) or rocuronium (GR) before tracheal intubation. After placement in prone position, neuromuscular transmission was monitored at the wrist by accelerometry. NMB was antagonised when the TOF ratio (TOFR) was < 0.75 at muscle closure. The time from muscle relaxant to muscle closure, and to TOFR of 0.25 and of 0.50 were recorded. Data were analysed using Student's t-tests, chi-squared tests and two-way mixed-designed ANOVA's. The prediction probability (Pk) of the times from muscle relaxant to muscle closure, and to TOFR of 0.25 for the necessity to antagonize NMB was calculated in both groups. P < 0.05 was considered statistically significant. RESULTS: NMB was antagonized in 8 (GC) and 6 (GR) patients, respectively. The time from muscle relaxant to muscle closure was shorter in patients whose NMB was antagonized. The Pk of this time was significant in GC (0.85) but not in GR (0.69). In GR contrarily to GC, the times to a TOFR of 0.25 and 0.50 were longer in patients whose NMB was antagonized. The Pk of the time to TOFR of 0.25 was significant in GR (0.95) but not in GC (0.64). CONCLUSIONS: A single dose of cisatracurium or rocuronium may be associated to some degree of NMB at the end of lumbar surgery, depending on the duration of surgery and on the duration of action of the muscle relaxant which is more variable for rocuronium than for cisatracurium. [less ▲]

Detailed reference viewed: 32 (2 ULg)
Full Text
See detailAnesthésie pour la chirurgie hypophysaire
Bonhomme, Vincent ULg; Franssen, Colette ULg; Hans, Pol ULg

in Ravussin, Patrick; Vincent, Jean-Louis; Martin, C. (Eds.) Le point sur le patient neuro-chirurgical (2004)

Detailed reference viewed: 66 (1 ULg)
Full Text
Peer Reviewed
See detailThe rationale for perioperative brain protection
Hans, Pol ULg; Bonhomme, Vincent ULg

in European Journal of Anaesthesiology (2004), 21(1), 1-5

Perioperative brain protection refers to prophylactic measures instituted during the perioperative period to prevent or reduce ischaemic damage and to improve neurological outcome. In that context ... [more ▼]

Perioperative brain protection refers to prophylactic measures instituted during the perioperative period to prevent or reduce ischaemic damage and to improve neurological outcome. In that context, strategies for protecting the brain rely on the control of physiological variables, anaesthesia, administration of non-anaesthetic pharmacological agents and preconditioning. Avoiding hyperthermia, hyperglycaemia and arterial hypotension are passive neuroprotective measures acknowledged in human beings. The protective effect of anaesthesia, compared to the awake state, is demonstrated in animals but remains to be validated in clinical practice. Laboratory studies investigating pharmacological neuroprotection have shown interesting results but most clinical trials have been disappointing except for a few drugs in specific settings. Preconditioning which results in the induction of some resistance to ischaemia appears as a promising strategy. Up to now, the translation of beneficial experimental results into clinical success is considered an entirely permissible hope but remains an unachieved objective. [less ▲]

Detailed reference viewed: 82 (1 ULg)
Full Text
Peer Reviewed
See detailPotential neuroprotective properties of atracurium and cisatracurium in neurosurgical anaesthesia
Hans, Pol ULg; Bonhomme, Vincent ULg

in European Journal of Anaesthesiology (2004), 21(4), 334-335

Detailed reference viewed: 11 (0 ULg)
Full Text
Peer Reviewed
See detailPrise en charge anesthesique des craniotomies en etat vigile.
Bonhomme, Vincent ULg; Born, J.-D.; Hans, Pol ULg

in Annales Françaises d'Anesthésie et de Réanimation (2004), 23(4), 389-94

This review article presents a detailed analysis of patients' management for awake craniotomy, at the light of the available data in the literature and the authors' experience. Indications of this type of ... [more ▼]

This review article presents a detailed analysis of patients' management for awake craniotomy, at the light of the available data in the literature and the authors' experience. Indications of this type of surgery are discussed as well as anaesthetic management itself, from preoperative assessment of the patient to peroperative concerns. Anaesthetic strategy, choice of anaesthetic agents, anaesthetic technique, and management of the airway and possible complications are discussed. The authors emphasize the tricky aspect of the procedure, the necessity of rigorous patient selection and good preparation. They emphasize the need for controlled studies to validate the proposed techniques. [less ▲]

Detailed reference viewed: 42 (2 ULg)
Full Text
Peer Reviewed
See detailMonitoring depth of anaesthesia: is it worth the effort?
Bonhomme, Vincent ULg; Hans, Pol ULg

in European Journal of Anaesthesiology (2004), 21(6), 423-8

In this review paper, the authors critically analyse the use of a number of depth of anaesthesia monitors in light of the most recent literature and their own clinical experience. There appears to be ... [more ▼]

In this review paper, the authors critically analyse the use of a number of depth of anaesthesia monitors in light of the most recent literature and their own clinical experience. There appears to be increasing evidence that anaesthesia depth monitors reduce the incidence of unexpected intraoperative awareness and also that they improve the quality of anaesthesia. Proper use of these monitors necessitates background knowledge about the physiology of the loss of consciousness, the type of variable recorded and processed by the monitoring devices, the factors that might interfere with recording and the limits of use. The information provided by anaesthesia depth monitors is detailed and relationships with clinical practice are established to provide the reader with key features for optimal use of those monitors and correct interpretation of data. Practitioners and patient's knowledge and expectations regarding this matter, as well as the cost-benefit relationship are also discussed. [less ▲]

Detailed reference viewed: 18 (1 ULg)
Full Text
See detailLes agents anesthésiques hypnotiques, les opiacés et les myorelaxants en neuroanesthésie
Albanèse, J.; Bonhomme, Vincent ULg; Hans, Pol ULg

in Ravussin, Patrick; Vincent, Jean-Louis; Martin, C. (Eds.) Le point sur le patient neuro-chirurgical (2004)

Detailed reference viewed: 45 (2 ULg)
Full Text
Peer Reviewed
See detailEffect of intra-operative magnesium sulphate on pain relief and patient comfort after major lumbar orthopaedic surgery
Levaux, Christine ULg; Bonhomme, Vincent ULg; Dewandre, Pierre-Yves et al

in Anaesthesia (2003), 58(2), 131-135

The effects of intra-operative magnesium sulphate on pain relief after major lumbar surgery were investigated in 24 patients. Patients were randomly allocated to receive either an infusion of 50 mg x kg ... [more ▼]

The effects of intra-operative magnesium sulphate on pain relief after major lumbar surgery were investigated in 24 patients. Patients were randomly allocated to receive either an infusion of 50 mg x kg(-1) magnesium sulphate or an equivalent volume of saline at induction of anaesthesia. Anaesthesia was induced with propofol and remifentanil. Tracheal intubation was facilitated using rocuronium. Maintenance was achieved with remifentanil and sevoflurane in nitrous oxide/ oxygen. Intra-operative monitoring included standard equipment and neuromuscular transmission. During surgery, neuromuscular block recovery was longer in the magnesium group. Postoperative opioid consumption and pain scores were lower in the magnesium group. The first night's sleep and the global satisfaction scores were better in the magnesium group. The results of the study support magnesium sulphate as a useful adjuvant for postoperative analgesia after major lumbar surgery. [less ▲]

Detailed reference viewed: 48 (2 ULg)
Full Text
Peer Reviewed
See detailEpidural hematoma after cervical spine surgery.
Hans, Pol ULg; Delleuze, Pierre Philippe; Born, Jacques Daniel et al

in Journal of Neurosurgical Anesthesiology (2003), 15(3), 282-5

The authors report an acute epidural hematoma after the surgical removal of a cervical C6-C7 disc herniation through an anterolateral approach of the cervical spine. Clinical history consisted of ... [more ▼]

The authors report an acute epidural hematoma after the surgical removal of a cervical C6-C7 disc herniation through an anterolateral approach of the cervical spine. Clinical history consisted of respiratory distress and flaccid tetraplegia that appeared 2.5 hours after surgery. Without any complementary radiologic investigation, the patient was immediately transferred to the operating room for a second look, which was unsuccessful. Magnetic resonance imaging performed after this second surgical procedure showed an anterior cervical hematoma extending from C3 to T3 without significant spinal cord compression. A cervical laminectomy was performed to evacuate the hematoma. The patient was extubated the next morning and discharged from the hospital after 5 days with no residual neurologic deficit. An extensive postoperative investigation revealed no coagulation disorder. [less ▲]

Detailed reference viewed: 53 (1 ULg)
Full Text
Peer Reviewed
See detailMuscle relaxants in neurosurgical anaesthesia: a critical appraisal.
Hans, Pol ULg; Bonhomme, Vincent ULg

in European Journal of Anaesthesiology (2003), 20(8), 600-5

The use of muscle relaxants, considered until recently as common practice in current neurosurgical anaesthesia protocols, becomes increasingly more questionable today. The reasons rely on the evolution of ... [more ▼]

The use of muscle relaxants, considered until recently as common practice in current neurosurgical anaesthesia protocols, becomes increasingly more questionable today. The reasons rely on the evolution of neurosurgery including the advent of new surgical techniques, the evolution of anaesthesia having the benefit of new drugs and devices, and the rationale for using muscle relaxants balanced against their potential side-effects and possible pharmacodynamic alterations in neurosurgical patients. [less ▲]

Detailed reference viewed: 16 (0 ULg)
Full Text
Peer Reviewed
See detailEpidural administration of low-dose morphine combined with clonidine for postoperative analgesia after lumbar disc surgery
Bonhomme, Vincent ULg; Doll, Anne; Dewandre, Pierre-Yves et al

in Journal of Neurosurgical Anesthesiology (2002), 14(1), 1-6

This study evaluates the efficacy and side effects of a low dose of epidural morphine combined with clonidine for postoperative pain relief after lumbar disc surgery. In 36 of 51 patients who accepted the ... [more ▼]

This study evaluates the efficacy and side effects of a low dose of epidural morphine combined with clonidine for postoperative pain relief after lumbar disc surgery. In 36 of 51 patients who accepted the procedure, an epidural catheter was inserted (L1-L2 level). General anesthesia was induced with propofol and sufentanil, and maintained with sevoflurane in O2/N2O. After emergence from anesthesia, epidural analgesia was initiated according to two randomly assigned protocols: 1 mg of morphine with 75 microg of clonidine (Group M) or 12.5 mg of bupivacaine with 75 microg of clonidine (Group B), in 10 mL saline. Piritramide was administered during the first postoperative 24 hours using a patient-controlled analgesia device (PCA). The following parameters were recorded: piritramide consumption during the first 24 hours; pain at rest during the first postoperative hours (D0), during the first night (D1), and during the first mobilization; [visual analogue scale (VAS)]; and the occurrence of drowsiness, motor blockade, respiratory depression, nausea, vomiting, itching, micturition problems, and bladder catheterization during D0 and D1. Epidural administration of morphine-clonidine significantly improved postoperative pain relief and reduced piritramide consumption as compared to epidural bupivacaine-clonidine. Side effects did not differ between groups except for a higher incidence of micturition problems in Group M during D1. The occurrence of bladder catheterization was not significantly higher in that group. We conclude that a low dose of epidural morphine combined with clonidine offers a better postoperative analgesia than does bupivacaine-clonidine. The excellent analgesic conditions were obtained at the expense of a higher incidence of difficulties in initiating micturition. [less ▲]

Detailed reference viewed: 46 (6 ULg)
Full Text
Peer Reviewed
See detailRéanimation cardiopulmonaire chez la femme enceinte
Brichant, Jean-François ULg; Dewandre, Pierre-Yves ULg; Bonhomme, Vincent ULg et al

in Praticien en Anesthésie Réanimation (Le) (2002), 6

Detailed reference viewed: 88 (11 ULg)
Full Text
Peer Reviewed
See detailEffect of Nitrous Oxide on the Bispectral Index and the 95% Spectral Edge Frequency of the Electroencephalogram During Surgery
Hans, Pol ULg; Bonhomme, Vincent ULg; Benmansour, H. et al

in Anaesthesia (2001), 56(10), 999-1002

We studied the effect of nitrous oxide on the bispectral index and 95% spectral edge frequency of the electroencephalogram in 20 patients undergoing lumbar surgery under general anaesthesia combined with ... [more ▼]

We studied the effect of nitrous oxide on the bispectral index and 95% spectral edge frequency of the electroencephalogram in 20 patients undergoing lumbar surgery under general anaesthesia combined with epidural administration of 5 mg morphine. [less ▲]

Detailed reference viewed: 38 (4 ULg)