References of "Brichant, Jean-François"
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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 ▲]

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See detailOverexpression of the soluble vascular endothelial growth factor receptor in preeclamptic patients: Pathophysiological consequences
Tsatsaris, V.; Goffin, Frédéric ULg; Munaut, Carine ULg et al

in Journal of Clinical Endocrinology and Metabolism (2003), 88(11), 5555-5563

Several growth factors such as vascular endothelial growth factor (VEGF)-A and placental growth factor (PlGF) are involved in the placental vascular development. We investigated whether dysregulation in ... [more ▼]

Several growth factors such as vascular endothelial growth factor (VEGF)-A and placental growth factor (PlGF) are involved in the placental vascular development. We investigated whether dysregulation in the VEGF family may explain the defective uteroplacental vascularization characterizing preeclampsia. We compared pregnancies complicated by early onset severe preeclampsia or intrauterine growth retardation to normal pregnancies. Maternal plasma, placentas, and placental bed biopsies were collected. The mRNA levels of VEGF-A, PlGF, and their receptors were quantified in placentas and placental beds. Levels of VEGF-A, PlGF, and soluble VEGF receptor (VEGFR) were assessed in maternal plasma. In compromised pregnancies, elevated levels of VEGF-A and VEGFR-1 mRNAs may reflect the hypoxic status of the placenta. On contrast, the membrane-bound VEGFR-1 was decreased in the placental bed of preeclamptic patients. Preeclampsia was associated with low levels of circulating PlGF and increased levels of total VEGF-A and soluble VEGFR-1. Free VEGF-A was undetectable in maternal blood. Immunohistochemical studies revealed that VEGF-A and PlGF were localized in trophoblastic cells. Altogether, our results suggest two different pathophysiological mechanisms associated with preeclampsia. The first one is related to an overproduction of competitive soluble VEGFR-1 that may lead to suppression of VEGF-A and PlGF effects. The second one is the down-regulation of its membrane bound form (VEGFR-1) in the placental bed, which may result in the defective uteroplacental development. [less ▲]

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See detailAnesthésie obstétrical et pathologie respiratoire
Brichant, Jean-François ULg

Conference (2003, September)

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See detailRespiratory catastrophes during anaesthesia: bronchospasm
Brichant, Jean-François ULg

Conference (2003, May)

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See detailQuelles mesures de stérilité pour les blocs locorégionaux
Brichant, Jean-François ULg

Conference (2003, March)

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See detailPreoperative assessment of the patient undergoing chest surgery
Brichant, Jean-François ULg

Conference (2003, March)

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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 ▲]

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See detailQuelles mesures de stérilité pour les blocs centraux au bloc d'accouchement?
Brichant, Jean-François ULg

in Le risque infectieux en anesthésie (JEPU) (2003)

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See detailAnesthésie de la femme enceinte. Les risques pour la mère et l'enfant
Brichant, Jean-François ULg

Conference (2002, November 04)

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See detailPathologie respiratoire et anesthésie osbtétricale
Brichant, Jean-François ULg

Conference (2002, September)

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See detailHypoxic pulmonary vasoconstriction and anaesthesia
Brichant, Jean-François ULg

Conference (2002, April)

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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 ▲]

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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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