Total intravenous anesthesia in South-African genetic porphyria (variegate porphyria)
; Joris, Jean ; et al
in Acta Anaesthesiologica Belgica (1993), 44(1), 25-29Detailed reference viewed: 25 (0 ULg)
Analgésie médullaire. Association anesthésiques locaux - opiacés: modalités d'utilisation
in Analgésie péri-opératoire (1993)Detailed reference viewed: 17 (0 ULg)
Une salle d'analgésie postopératoire: une alternative à l'Acute Pain Service
Joris, Jean ; Lamy, Maurice
in Douleur et analgésie (1993), 2Detailed reference viewed: 24 (3 ULg)
Clonidine and ketanserin both are effective treatment for postanesthetic shivering.
Joris, Jean ; ; et al
in Anesthesiology (1993), 79(3), 532-9
BACKGROUND: Although meperidine is an effective treatment of postanesthetic shivering, its mechanism of action remains unknown. Investigation of other drugs might help clarify the mechanisms by which ... [more ▼]
BACKGROUND: Although meperidine is an effective treatment of postanesthetic shivering, its mechanism of action remains unknown. Investigation of other drugs might help clarify the mechanisms by which shivering can be controlled. Accordingly, we investigated the efficacy of clonidine, an alpha 2-adrenergic agonist, and ketanserin, a 5-hydroxytryptamine antagonist, in treating postanesthetic shivering. METHODS: First, 54 patients shivering after general anesthesia were allocated randomly to receive an intravenous bolus of saline, 150 micrograms clonidine, or 10 mg ketanserin. A second study explored the dose-dependence of clonidine. Forty shivering patients were given saline or clonidine, 37.5, 75, or 150 micrograms. RESULTS: The duration of shivering was significantly shorter in those given clonidine (2.1 +/- 0.9 min) than in the other two groups and shorter in the ketanserin group (4.3 +/- 0.9 min) than in the saline group (12.0 +/- 1.6 min). Clonidine and ketanserin significantly decreased systolic arterial blood pressure when compared to saline. Core rewarming was significantly slower in the clonidine group. In the second study, 37.5 micrograms clonidine was no more effective than saline. Two minutes after treatment, 150 micrograms obliterated shivering in all patients. Five minutes after treatment, all patients given 75 micrograms had stopped shivering. Systolic arterial pressure and heart rate decreased significantly in patients given 75 and 150 micrograms clonidine. CONCLUSIONS: Clonidine (150 micrograms) and ketanserin (10 mg) both are effective treatment for postanesthetic shivering. The effect of clonidine on shivering is dose-dependent: whereas 37.5 micrograms had no effect, 75 micrograms clonidine stopped shivering within 5 min. [less ▲]Detailed reference viewed: 28 (1 ULg)
Analgésie postopératoire par analgésie péridurale autocontrôlée
in Douleur et analgésie (1993), 4Detailed reference viewed: 17 (2 ULg)
Amiodarone-induced thyrotoxicosis: is there a place for surgery?
Meurisse, Michel ; Hamoir, Etienne ; et al
in World Journal of Surgery (1993), 17(5), 622-6627
Amiodarone-induced hyperthyroidism has on most instances been reported as mild, and thyroid functions return to normal after discontinuation of the drug. Nevertheless, life-threatening amiodarone-induced ... [more ▼]
Amiodarone-induced hyperthyroidism has on most instances been reported as mild, and thyroid functions return to normal after discontinuation of the drug. Nevertheless, life-threatening amiodarone-induced thyrotoxicosis has also been described. Conventional treatments such as antithyroid drugs (thionamide) and corticosteroids are essentially ineffective or fail to alter the dramatic course of the thyroid crisis. This limited effectiveness of medical therapy, particularly in patients with previously neglected or unknown thyroid disease, prompted us to intervene surgically. We report a series of nine patients who underwent total or near-total thyroidectomy as a first-line therapy for five of them. Surgery resulted in rapid resolution of thyrotoxicosis with an uneventful postoperative course. This approach has the advantage of immediate effectivity, low risk of relapse, and appears to be the only treatment that permits continued therapy with amiodarone when the drug appears needed to control a life-threatening arrhythmia. [less ▲]Detailed reference viewed: 22 (0 ULg)
Metabolic and respiratory changes after cholecystectomy performed via laparotomy or laparoscopy.
Joris, Jean ; ; Legrand, Marc et al
in British Journal of Anaesthesia (1992), 69(4), 341-5
We have compared metabolic and respiratory changes after laparoscopic cholecystectomy (n = 15) with those after open cholecystectomy (n = 15). The durations of postoperative i.v. therapy, fasting and ... [more ▼]
We have compared metabolic and respiratory changes after laparoscopic cholecystectomy (n = 15) with those after open cholecystectomy (n = 15). The durations of postoperative i.v. therapy, fasting and hospital stay were significantly shorter in the laparoscopy group. During the first and second days after operation, analgesic consumption but not pain scores (visual analogue scale) were significantly smaller after laparoscopy, while vital capacity, forced expiratory volume in 1 s, and PaO2 were significantly greater. The metabolic and acute phase responses (glucose, leucocytosis, C-reactive protein) were less after laparoscopy compared with laparotomy. Although plasma cortisol and catecholamine concentrations were not significantly different between the two groups, after surgery interleukin-6 concentrations were less in the laparoscopy group. [less ▲]Detailed reference viewed: 32 (0 ULg)
Aspects chirurgicaux du traitement des affections surrenaliennes.
Meurisse, Michel ; ; et al
in Acta Chirurgica Belgica (1991), 91(2), 107-11
With the greatly enhanced accuracy of current endocrinologic diagnosis assisted by precise diagnostic imaging, together with greatly enhanced preparation of patients with endocrinopathy for safer ... [more ▼]
With the greatly enhanced accuracy of current endocrinologic diagnosis assisted by precise diagnostic imaging, together with greatly enhanced preparation of patients with endocrinopathy for safer anesthetic and surgical procedure (e.g. adrenal cortical cancers, cortisol and aldosterone producing adenomas and pheochromocytomas), operative procedures can be planned and conducted more precisely. For the surgeon, the strategy for treatment of functional and neoplastic disorders of the adrenal glands has essentially to consider the anatomy of the suprarenal glands, the deleterious effects of hormone excess before and during operation, the presumed nature of incidentally discovered adrenal mass and the size of the tumor. [less ▲]Detailed reference viewed: 23 (0 ULg)
Interpleural, intercostal and thoracic epidural analgesia
in Current Opinion in Anaesthesiology (1991), 4Detailed reference viewed: 6 (0 ULg)
Opiates suppress carrageenan-induced edema and hyperthermia at doses that inhibit hyperalgesia
Joris, Jean ; ; et al
in Pain (1990), 43Detailed reference viewed: 10 (0 ULg)
Release from inflamed tissue of a substance with properties similar to corticotropin-releasing factor.
; ; Joris, Jean
in Neuroendocrinology (1989), 49(5), 476-82
In response to stressors involving tissue injury, pituitary corticotroph secretion of immunoreactive beta-endorphin (iB-END) could be either due to release of hypothalamic factors such as corticotropin ... [more ▼]
In response to stressors involving tissue injury, pituitary corticotroph secretion of immunoreactive beta-endorphin (iB-END) could be either due to release of hypothalamic factors such as corticotropin-releasing factor (CRF) or to release of a tissue factor from the periphery. In the present experiments, we investigated whether inflamed tissue releases a factor which evokes pituitary secretion of iB-END. In an initial experiment, rats with an inflamed hindpaw due to carrageenan injection had significantly greater levels of circulating iB-END as compared to rats with saline-injected paws. Removal of afferent input, by hindlimb denervation, failed to block the carrageenan-induced increase in iB-END levels. Subcutaneous perfusates were then collected from inflamed and control hindlimbs and applied to rat anterior pituitary cell cultures. Pituitary release of iB-END due to administration of perfusate from inflamed paws was significantly greater than iB-END release due to perfusate from saline-injected paws or to basal release. The releasing activity in the perfusates was blocked in calcium-free medium and was not due to a direct action of carrageenan, bradykinin, substance P or calcitonin gene-related peptide. The results indicate that inflamed tissue releases a CRF-like factor which stimulates iB-END release both in the denervated rat and cultured pituitary cells. [less ▲]Detailed reference viewed: 5 (0 ULg)
Effect of diclofenac on plasma levels of immunoreactive prolactin, follicle stimulating hormone, luteinizing hormone, thyrotropin, and B-endorphin in humans
Joris, Jean ; ; et al
in Hormone Research (1988), 29Detailed reference viewed: 31 (0 ULg)
A new and sensitive method for measuring thermal nociception in cutaneous hyperalgesia.
; ; et al
in Pain (1988), 32(1), 77-88
A method to measure cutaneous hyperalgesia to thermal stimulation in unrestrained animals is described. The testing paradigm uses an automated detection of the behavioral end-point; repeated testing does ... [more ▼]
A method to measure cutaneous hyperalgesia to thermal stimulation in unrestrained animals is described. The testing paradigm uses an automated detection of the behavioral end-point; repeated testing does not contribute to the development of the observed hyperalgesia. Carrageenan-induced inflammation resulted in significantly shorter paw withdrawal latencies as compared to saline-treated paws and these latency changes corresponded to a decreased thermal nociceptive threshold. Both the thermal method and the Randall-Selitto mechanical method detected dose-related hyperalgesia and its blockade by either morphine or indomethacin. However, the thermal method showed greater bioassay sensitivity and allowed for the measurement of other behavioral parameters in addition to the nociceptive threshold. [less ▲]Detailed reference viewed: 85 (0 ULg)
Bradykinin is increased during acute and chronic inflammation: therapeutic implications.
; ; et al
in Clinical Pharmacology & Therapeutics (1988), 44(6), 613-21
Bradykinin is a potent pain-producing substance, yet little is known about its role in inflammation. The present study measured circulating levels of immunoreactive bradykinin in a clinical model of acute ... [more ▼]
Bradykinin is a potent pain-producing substance, yet little is known about its role in inflammation. The present study measured circulating levels of immunoreactive bradykinin in a clinical model of acute inflammation (oral surgery) and chronic inflammation (rheumatoid arthritis) and in the rat carrageenan model of inflammation. The effects of a kallikrein inhibitor (soybean trypsin inhibitor) on blocking bradykinin synthesis in vitro and its analgesic actions in the rat model were also evaluated. Levels of immunoreactive bradykinin increased threefold to fourfold during oral surgery. Levels were twofold to threefold greater in patients with rheumatoid arthritis compared with control subjects. Levels of immunoreactive bradykinin increased twofold in rats during carrageenan inflammation. Soybean trypsin inhibitor blocked synthesis of bradykinin in vitro and possessed analgesic activity in rats. The results indicate that the bradykinin system is activated during inflammation. Kallikrein inhibitors may represent a new class of analgesic/antiinflammatory drugs. [less ▲]Detailed reference viewed: 20 (0 ULg)