References of "Brichant, Jean-François"
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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

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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 ▲]

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See detailTarget-Controlled Infusion of Propofol and Remifentanil Combined with Bispectral Index Monitoring for Awake Craniotomy
Hans, Pol ULg; Bonhomme, Vincent ULg; Born, J. D. et al

in Anaesthesia (2000), 55(3), 255-9

We describe the target-controlled administration of propofol and remifentanil, combined with monitoring of the bispectral index, during an awake craniotomy for removal of a left temporo-parietal tumour ... [more ▼]

We describe the target-controlled administration of propofol and remifentanil, combined with monitoring of the bispectral index, during an awake craniotomy for removal of a left temporo-parietal tumour near the motor speech centre. Target concentrations of the two drugs were adjusted according to the patient's responses to painful stimuli and surgical events, and the need for speech testing. Allowing the effect-site concentrations of propofol and remifentanil to decrease during surgery allowed the performance of cortical speech mapping and the testing of the patient's ability to speak. Although the bispectral index was not used as a guide for the administration of the drugs, its value correlated better with the patient's responsiveness than did the predicted effect-site concentrations of propofol. Side-effects, comprising hypotension, respiratory depression and airway obstruction, were related to rapid increases in drug infusion rates and were easily managed. [less ▲]

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See detailRandomized Trial of Diaspirin Cross-Linked Hemoglobin Solution as an Alternative to Blood Transfusion after Cardiac Surgery. The Dclhb Cardiac Surgery Trial Collaborative Group
Lamy, Maurice ULg; Daily, Elaine K.; Brichant, Jean-François ULg et al

in Anesthesiology (2000), 92(3), 646-56

BACKGROUND: Risks associated with transfusion of allogeneic blood have prompted development of methods to avoid or reduce blood transfusions. New oxygen-carrying compounds such as diaspirin cross-linked ... [more ▼]

BACKGROUND: Risks associated with transfusion of allogeneic blood have prompted development of methods to avoid or reduce blood transfusions. New oxygen-carrying compounds such as diaspirin cross-linked hemoglobin (DCLHb) could enable more patients to avoid allogeneic blood transfusion. METHODS: The efficacy, safety, hemodynamic effects, and plasma persistence of DCLHb were investigated in a randomized, active-control, single-blind, multicenter study in post-cardiac bypass surgery patients. Of 1,956 screened patients, 209 were determined to require a blood transfusion and met the inclusion criteria during the 24-h post-cardiac bypass period. These patients were randomized to receive up to three 250-ml infusions of DCLHb (n = 104) or three units of packed erythrocytes (pRBCs; n = 105). Further transfusions of pRBCs or whole blood were permitted, if indicated. Primary efficacy end points were the avoidance of blood transfusion through hospital discharge or 7 days postsurgery, whichever came first, and a reduction in the number of units of pRBCs transfused during this same time period. Various laboratory, physiologic, and hemodynamic parameters were monitored to define the safety and pharmacologic effect of DCLHb in this patient population. RESULTS: During the period from the end of cardiopulmonary bypass surgery through postoperative day 7 or hospital discharge, 20 of 104 (19%) DCLHb recipients did not receive a transfusion of pRBCs compared with 100% of control patients (P < 0.05). The overall number of pRBCs administered during the 7-day postoperative period was not significantly different. Mortality was similar between the DCLHb (6 of 104 patients) and the control (8 of 105 patients) groups. Hypertension, jaundice/hyperbilirubinemia, increased serum glutamic oxalo-acetic transaminase, abnormal urine, and hematuria were reported more frequently in the DCLHb group, and there was one case of renal failure in each group. The hemodynamic effects of DCLHb included a consistent and slightly greater increase in systemic and pulmonary vascular resistance with associated increases in systemic and pulmonary arterial pressures compared with pRBC. Cardiac output values decreased more in the DCLHb group patients after the first administration than the control group patients. At 24 h postinfusion, the plasma hemoglobin level was less than one half the maximal level for any amount of DCLHb infused. CONCLUSIONS: Administration of DCLHb allowed a significant number (19%) of cardiac surgery patients to avoid exposure to erythrocytes postoperatively. [less ▲]

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See detailEffects of Mild Hypothermic Cardiopulmonary Bypass on Eeg Bispectral Index
Dewandre, Pierre-Yves; Hans, Pol ULg; Bonhomme, Vincent ULg et al

in Acta Anaesthesiologica Belgica (2000), 51(3), 187-90

We studied the effect of mild hypothermic cardiopulmonary bypass (30 degrees C) on the EEG Bispectral Index in 10 patients undergoing elective CABG. BIS was recorded at 11 event-related time points during ... [more ▼]

We studied the effect of mild hypothermic cardiopulmonary bypass (30 degrees C) on the EEG Bispectral Index in 10 patients undergoing elective CABG. BIS was recorded at 11 event-related time points during the procedure. After a significant decrease at the induction of anaesthesia, BIS was not further modified during the procedure. BIS was neither affected by surgical stimulation nor by CPB and mild hypothermia. We conclude that we did not find any reason to preclude the use of BIS to assess the hypnotic effects of anaesthetics during normothermic or mild hypothermic CPB. [less ▲]

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See detailEffects of Ephedrine on the Onset Time of Neuromuscular Block and Intubating Conditions after Cisatracurium: Preliminary Results
Albert, Franz ULg; Hans, Pol ULg; Bitar, Yasser et al

in Acta Anaesthesiologica Belgica (2000), 51(3), 167-71

We studied the effects of intravenous ephedrine on the onset time and the intubating conditions 2 min after a bolus dose of cisatracurium (0.15 mg kg-1). Thirty patients anaesthetized with sufentanil and ... [more ▼]

We studied the effects of intravenous ephedrine on the onset time and the intubating conditions 2 min after a bolus dose of cisatracurium (0.15 mg kg-1). Thirty patients anaesthetized with sufentanil and propofol were randomly divided in 2 groups to receive either ephedrine (70 micrograms.kg-1) or saline, 5 s before propofol. Cisatracurium was administered after loss of consciousness. Neuromuscular block was assessed at the adductor pollicis using accelography. Tracheal intubation was performed 2 min after cisatracurium injection and rated as excellent, good, poor or bad. At intubation, neuromuscular block (% height of control T1) was greater in patients receiving ephedrine (36.1 +/- 25.8% vs 57.9 +/- 25.1%) (mean +/- SD). The frequency of excellent intubating conditions was higher after ephedrine (86.6%) than after saline (40.0%). The onset time of cisatracurium was shorter after ephedrine (167 +/- 64.8 s vs 234.9 +/- 63.1 s). Thus, a low dose of ephedrine given before induction of anaesthesia improves the intubating conditions 2 min after 0.15 mg kg-1 cisatracurium and this effect likely relates to a quicker onset of neuromuscular block. [less ▲]

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See detailBegian guidelines concerning drug induced alteration of coagulation and central neuraxial anesthesia
Brichant, Jean-François ULg; De Kock, Marc; De Mey, J. C. et al

in Acta Anaesthesiologica Belgica (2000), 51

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See detailEffect of Epidural Bupivacaine on the Relationship between the Bispectral Index and End-Expiratory Concentrations of Desflurane
Hans, Pol ULg; Lecoq, Jean-Pierre; Brichant, Jean-François ULg et al

in Anaesthesia (1999), 54(9), 899-902

We compared the relationship between the bispectral index and end-tidal desflurane concentrations in 20 patients undergoing elective surgery. Patients received epidurally either 10 ml saline (group S) or ... [more ▼]

We compared the relationship between the bispectral index and end-tidal desflurane concentrations in 20 patients undergoing elective surgery. Patients received epidurally either 10 ml saline (group S) or 10 ml bupivacaine 0.125% with epinephrine 1/800 000 (group B) before induction of anaesthesia with sufentanil (0.15 microgram.kg(-1)) and propofol (2 mg.kg(-1)); muscle relaxation was obtained with cisatracurium (0.2 mg.kg(-1)). Patients lungs were ventilated to maintain end-tidal desflurane at 3% in O2/N2O (50/50) until 5 min after skin incision, followed by two consecutive 10 min periods at end-tidal desflurane 6% and 9%. bispectral index values were recorded before induction, at 3% desflurane before and 5 min after skin incision, and at 6% and 9% end-tidal desflurane. Bispectral index decreased with increasing end-tidal desflurane concentration (ANOVA: p < 0.05). The decrease in bispectral index was significant between pre-induction, 3% and 6% desflurane. No significant difference was observed at 3% desflurane before and after skin incision, or between 6 and 9% desflurane. The relationship between bispectral index and end-tidal desflurane concentration was fitted by a linear regression in each group. No significant difference in bispectral index was observed between the groups at any time. We conclude that bispectral index decreases with increasing desflurane concentration and that this relationship is not affected by epidural 0.125% bupivacaine. [less ▲]

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See detailAnesthesie, analgesie et femme enceinte: une association a haut risque!
Brichant, Jean-François ULg; Incagnoli, P.

in Revue Médicale de Liège (1999), 54(5), 448-59

The authors review the changes in obstetric anesthesia and analgesia that have contributed to a decreased maternal mortality as well as those accounting for the clinically significant improvements of ... [more ▼]

The authors review the changes in obstetric anesthesia and analgesia that have contributed to a decreased maternal mortality as well as those accounting for the clinically significant improvements of maternal and neonatal morbidity. [less ▲]

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See detailEffects of Two Calculated Plasma Sufentanil Concentrations on the Hemodynamic and Bispectral Index Responses to Mayfield Head Holder Application
Hans, Pol ULg; Brichant, Jean-François ULg; Dewandre, Pierre-Yves et al

in Journal of Neurosurgical Anesthesiology (1999), 11(2), 81-5

The effects of two calculated plasma sufentanil (SUF) concentrations on the hemodynamic and bispectral index (BIS) responses to Mayfield head holder (MH) application were studied in 20 patients scheduled ... [more ▼]

The effects of two calculated plasma sufentanil (SUF) concentrations on the hemodynamic and bispectral index (BIS) responses to Mayfield head holder (MH) application were studied in 20 patients scheduled for intracranial surgery. Premedication consisted of hydroxyzine, alprazolam, and atropine given orally 1 hour before surgery. Anesthesia was provided with propofol (PPF) and SUF using a target-controlled infusion device. Patients were randomly assigned to one of two groups according to calculated plasma concentrations: 3 microg/mL(-1) of PPF and 0.5 ng/mL(-1) of SUF in group I (GI) and 3 microg/mL(-1) of PPF and 1 ng/mL(-1) of SUF in group II (GII). The MH was fixed 33.0+/-6.6 minutes (mean +/- SD) after induction. Systolic (SAP), diastolic (DAP), and mean arterial pressure (MAP) as well as heart rate (HR) and BIS were recorded 1 minute before pinning (baseline) as well as 1 minute (P1), 2 minutes (P2), and 3 minutes (P3) after pinning. Multivariate repeat-measured analyses of variance were applied to the baseline-subtracted measurements of hemodynamic and BIS values. Groups were compared using the Student's t test, and P < .05 was considered to be statistically significant. Patients' characteristics, baseline hemodynamic values, and BIS values were similar in both groups. A significant overall time effect was observed for all variables, but no significant overall SUF effect was detected. Increases in SAP, MAP, DAP, and HR did not differ significantly between groups. The increase in hemodynamic variables did not exceed 20% of baseline value in either group. In contrast, at P1, the increase in BIS over the baseline value was significantly higher in GI (15.0+/-7.9) than in GII (6.7+/-6.5). In conclusion, MH application was associated with a significant, although not clinically relevant, increase in hemodynamic variables whatever the calculated plasma SUF concentration (0.5 or 1.0 ng/mL(-1)). In contrast, the increase in BIS observed at pinning was significantly higher in patients with the lowest calculated plasma SUF concentrations. This suggests that the BIS response to noxious stimulation is modulated by the analgesic regimen. [less ▲]

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See detailInfluence of Induction of Anaesthesia on Intubating Conditions One Minute after Rocuronium Administration: Comparison of Ketamine and Thiopentone
Hans, Pol ULg; Brichant, Jean-François ULg; Hubert, B. et al

in Anaesthesia (1999), 54(3), 276-9

We compared the effect of thiopentone and ketamine on intubating conditions after rocuronium 0.6 mg.kg-1 in two groups of patients (n = 16 each), aged 21-44 years, undergoing elective surgery ... [more ▼]

We compared the effect of thiopentone and ketamine on intubating conditions after rocuronium 0.6 mg.kg-1 in two groups of patients (n = 16 each), aged 21-44 years, undergoing elective surgery. Premedication consisted of alprazolam 1 mg by mouth 1 h before surgery. All patients received midazolam 2 mg intravenously 2 min before intravenous administration of thiopentone 5 mg.kg-1 or ketamine 2.5 mg.kg-1. Muscle relaxation was provided by rocuronium 0.6 mg.kg-1. One minute after rocuronium administration, tracheal intubation was performed within 15 s by a skilled anaesthetist blinded to the treatment group assignment. Intubating conditions were graded as excellent, good, fair or poor on the basis of jaw relaxation, position of vocal cords and diaphragmatic response. Neuromuscular transmission was assessed at the adductor pollicis muscle using a TOF-GUARD monitor. Excellent and good intubating conditions were obtained in 100% of patients in the ketamine group and in 50% of patients in the thiopentone group (p = 0.002). Jaw relaxation was similar in both groups but vocal cord conditions were better and the diaphragmatic response less marked in the ketamine group compared with the thiopentone group (p = 0.002). The degree of neuromuscular block [% decrease of T1, mean (SD)] at the time of intubation was similar: 51.8 (25)% (ketamine group) and 54.3 (23.1)% (thiopentone group). We conclude that ketamine 2.5 mg.kg-1 provides better intubating conditions than thiopentone 5 mg.kg-1 1 min after administration of rocuronium 0.6 mg.kg-1. [less ▲]

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See detailMécanismes de l'action hypnotique des agents anesthésiques
Bonhomme, Vincent ULg; Brichant, Jean-François ULg; Dewandre, Pierre-Yves ULg et al

in Praticien en Anesthésie Réanimation (Le) (1999), 3

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See detailHemodynamic effects of epinephrine associated to an epidural clonidine-bupivacaine mixture during combined lumbar epidural and general anesthesia.
Senard, Marc ULg; Ledoux, Didier ULg; Darmont, Pascaline ULg et al

in Acta Anaesthesiologica Belgica (1998), 49(3), 167-73

Clonidine or epinephrine are frequently combined to epidural local anesthetics to strengthen sensory block and prolong analgesia. Both drugs impair the hemodynamic profile of central neural blockade but ... [more ▼]

Clonidine or epinephrine are frequently combined to epidural local anesthetics to strengthen sensory block and prolong analgesia. Both drugs impair the hemodynamic profile of central neural blockade but the effects of their combination on arterial pressure and heart rate are not known and were examined in this double-blind prospective randomised study. Forty four patients scheduled for lumbar disc surgery were allocated to two groups. Epidural anesthesia was obtained by administration of 150 micrograms clonidine in 15 ml bupivacaine 0.25% solution without (group C) or with (group C + E) 37.5 micrograms epinephrine. Systolic, mean, diastolic arterial pressure and heart rate were measured throughout the study. Combined epidural and general anesthesia induced a significant decrease in arterial pressure and heart rate in both groups. SAP and MAP decreased significantly less in the patients receiving epinephrine. Low dose epidural epinephrine decreases arterial pressure instability during combined epidural and general anesthesia. [less ▲]

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See detailLa ropivacaïne pour l'anesthésie et l'analgésie obstétricale: l'avenir?
Brichant, Jean-François ULg; Hans, Pol ULg

in Nouvelles techniques en anesthésie locorégionale (1998)

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See detailIntrathecal clonidine and fentanyl with hyperbaric bupivacaine improves analgesia during cesarean section
Benhamou, Dan; Schneider, Markus; Brichant, Jean-François ULg et al

in Anesthesia and Analgesia (1998), 87

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See detailEmergence from Target-Controlled Anesthesia with Propofol and Sufentanil in Patients Undergoing Intracranial Surgery
Hans, Pol ULg; Lamy, M. M.; Brichant, Jean-François ULg et al

in Acta Anaesthesiologica Belgica (1998), 49(1), 13-9

The study was designed to characterise the emergence from target-controlled anesthesia assessed by the recovery of spontaneous breathing, eye opening to command, and extubation in 18 adult patients ... [more ▼]

The study was designed to characterise the emergence from target-controlled anesthesia assessed by the recovery of spontaneous breathing, eye opening to command, and extubation in 18 adult patients undergoing intracranial surgery. Total intravenous anesthesia was induced and maintained with propofol and sufentanil. Target plasma concentration of propofol ranged between 3.0 and 5.5 micrograms.ml-1 and infusion was stopped after head dressing. The initial target plasma sufentanil concentration of 0.50 ng.ml-1 was decreased to 0.15 ng.ml-1 after craniotomy; sufentanil infusion was discontinued at the dura closure. The time from the end of surgery (head dressing) to recovery of spontaneous breathing was 8.3 +/- 6.5 min, and the time to eye opening and extubation was 14.7 +/- 10.0 min. At the end of surgery, the calculated plasma propofol concentration was 3.42 +/- 0.26 micrograms.ml-1. It significantly decreased to 2.11 +/- 0.51 micrograms.ml-1 at recovery of spontaneous breathing and to 1.81 +/- 0.41 micrograms.ml-1 at eye opening and extubation. The calculated plasma sufentanil concentration was 0.108 +/- 0.019 ng.ml-1 at the end of surgery but did not change significantly between recovery of spontaneous breathing (0.089 +/- 0.013 ng.ml-1), eye opening and extubation (0.087 +/- 0.013 ng.ml-1). The calculated plasma propofol concentrations recorded at emergence were not correlated with patient age, total dose of propofol, and duration of infusion; corresponding calculated sufentanil concentrations were not correlated with age and total dose of sufentanil. An inverse relationship (p < 0.05) was found between the duration of sufentanil infusion and the calculated sufentanil concentrations at emergence. No correlation was observed between calculated concentrations of propofol and sufentanil at emergence. [less ▲]

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See detailEffects of Target-Controlled Anesthesia with Propofol and Sufentanil on the Hemodynamic Response to Mayfield Head Holder Application
Hans, Pol ULg; Coussaert, E.; Cantraine, F. et al

in Acta Anaesthesiologica Belgica (1998), 49(1), 7-11

The effects of target-controlled anesthesia with propofol and sufentanil on the hemodynamic response to Mayfield head holder (MH) application were evaluated in 18 ASA I and II patients undergoing ... [more ▼]

The effects of target-controlled anesthesia with propofol and sufentanil on the hemodynamic response to Mayfield head holder (MH) application were evaluated in 18 ASA I and II patients undergoing scheduled intracranial surgery. Premedication consisted of hydroxyzine, alprazolam and atropine given orally 1 h before surgery. Anesthesia was provided with propofol and sufentanil using a target-controlled infusion device; constant calculated plasma concentrations of 4 micrograms ml-1 propofol and 0.5 ng ml-1 sufentanil were maintained throughout the study. Muscle relaxation was obtained with atracurium and ventilation was controlled with air/oxygen. The MH was fixed 45 +/- 12 min (mean +/- SD) after induction of anesthesia. Heart rate and systolic, diastolic, and mean non invasive arterial pressure were monitored and recorded 5 min before induction of anesthesia (control), 1 min before MH application (MH-1), at MH application, and 1 and 2 min after MH application. Systolic, diastolic, mean arterial pressure, and heart rate increased significantly during and after MH application when compared with MH-1 values, but remained constantly lower than control. Hemodynamic parameters measured 1 min before MH application were significantly lower than control. The results of the study indicate that target-controlled anesthesia maintained with constant calculated plasma concentrations of 4 micrograms ml-1 propofol and 0.5 ng ml-1 sufentanil prevents the increase in arterial pressure and heart rate beyond control values following MH application but may induce some degree of arterial hypotension in the absence of nociceptive stimulation. [less ▲]

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See detailOn the Intercostal Muscle Compensation for Diaphragmatic Paralysis in the Dog
Brichant, Jean-François ULg; De Troyer, A.

in Journal of Physiology (1997), 500((Pt 1)), 245-53

1. Paralysis of the diaphragm in the dog is known to cause a compensatory increase in activation of the inspiratory intercostal muscles (parasternal intercostals, external intercostals, and levator costae ... [more ▼]

1. Paralysis of the diaphragm in the dog is known to cause a compensatory increase in activation of the inspiratory intercostal muscles (parasternal intercostals, external intercostals, and levator costae). The present studies were designed to assess the mechanism(s) of that compensation. 2. Complete, selective diaphragmatic paralysis was induced by injecting local anaesthetic into small silicone cuffs placed around the phrenic nerve roots in the neck. 3. Paralysis produced a decrease in tidal volume and an increase in arterial P(CO2) (P(a,CO2)). The increased hypercapnic drive was a primary determinant of the increased inspiratory intercostal activity. 4. However, paralysis also produced an increased inspiratory cranial displacement of the ribs. When this increased rib displacement was reduced to that seen before paralysis, it appeared that the increase in external intercostal and levator costae inspiratory activity was commonly greater than anticipated on the basis of the increased P(a,CO2). 5. Diaphragmatic paralysis after bilateral vagotomy also elicited disproportionate increases in inspiratory intercostal activity, thus indicating that these increases are not caused by vagal afferent inputs. 6. These observations are consistent with the idea that the intercostal muscle compensation for diaphragmatic paralysis is, in part, due to the release of an inhibition originating from the contracting diaphragm. This inhibition might arise in the diaphragmatic tendon organs. [less ▲]

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