5 ans d’expérience monocentrique de transplantation hépatique avec des donneurs à cœur arrêté de catégorie 3 de Maastricht

in Journal de Chirurgie (2008, December), 145

Intraoperative ketamine increases BIS-guided sevoflurane requirements during combined general and thoracic epidural anaesthesia for major abdominal surgery

in Acta Anaesthesiologica Belgica (2008, June 14), 59(3), 201

Dose response curve of intravenous lidocaine on the depth of propofol - remifentanil anesthesia assessed byt the bispectral index (BIS) and A-line ARX index (AAI)

in Acta Anaesthesiologica Belgica (2008, June 14), 59(3), 205

Intravenous lidocaine reduces propofol requirement during propofol - remifentanil anaesthesia for thyroid surgery

in Acta Anaesthesiologica Belgica (2008, June 14), 59(3), 204

Pressure-controlled ventilation does not improve gas exchange in morbidly obese patients undergoing abdominal surgery

in Obesity Surgery (2008), 18(1), 71-76

Intravenous lidocaine infusion facilitates acute rehabilitation after laparoscopic colectomy

in Anesthesiology (2007), 106(1), 11-85-6

BACKGROUND: Intravenous infusion of lidocaine decreases postoperative pain and speeds the return of bowel function. The authors therefore tested the hypothesis that perioperative lidocaine infusion ... [more ▼]

BACKGROUND: Intravenous infusion of lidocaine decreases postoperative pain and speeds the return of bowel function. The authors therefore tested the hypothesis that perioperative lidocaine infusion facilitates acute rehabilitation protocol in patients undergoing laparoscopic colectomy. METHODS: Forty patients scheduled to undergo laparoscopic colectomy were randomly allocated to receive intravenous lidocaine (bolus injection of 1.5 mg/kg lidocaine at induction of anesthesia, then a continuous infusion of 2 mg.kg.h intraoperatively and 1.33 mg.kg.h for 24 h postoperatively) or an equal volume of saline. All patients received similar intensive postoperative rehabilitation. Postoperative pain scores, opioid consumption, and fatigue scores were measured. Times to first flatus, defecation, and hospital discharge were recorded. Postoperative endocrine (cortisol and catecholamines) and metabolic (leukocytes, C-reactive protein, and glucose) responses were measured for 48 h. Data (presented as median [25-75% interquartile range], lidocaine vs. saline groups) were analyzed using Mann-Whitney tests. P<0.05 was considered statistically significant. RESULTS: Patient demographics were similar in the two groups. Times to first flatus (17 [11-24] vs. 28 [25-33] h; P<0.001), defecation (28 [24-37] vs. 51 [41-70] h; P=0.001), and hospital discharge (2 [2-3] vs. 3 [3-4] days; P=0.001) were significantly shorter in patients who received lidocaine. Lidocaine significantly reduced opioid consumption (8 [5-18] vs. 22 [14-36] mg; P=0.005) and postoperative pain and fatigue scores. In contrast, endocrine and metabolic responses were similar in the two groups. CONCLUSIONS: Intravenous lidocaine improves postoperative analgesia, fatigue, and bowel function after laparoscopic colectomy. These benefits are associated with a significant reduction in hospital stay. [less ▲]

Complications in living liver donor according to Clavien's classification: An European experience

in Journal of Hepatology (2007), 46(Suppl. 1), 66

Bloodless cadaveric liver transplantation: Experience with Jehovah's witness recipients

in Journal of Hepatology (2007), 46(Suppl. 1), 67

L'infusion intraveineuse de lidocaine réduit les besoins en propofol lors d'une AIVOC associant remifentanil et propofol.

in Annales Françaises d'Anesthésie et de Réanimation (2006), 25

Liver transplantation in Jehovah's witnesses

in Transplant International (2005), 18(8), 929-936

For religious reasons, Jehovah's witnesses refuse transfusion of blood products (red cells, platelets, plasma), but may accept organ transplantation. The authors developed a multidisciplinary protocol for ... [more ▼]

For religious reasons, Jehovah's witnesses refuse transfusion of blood products (red cells, platelets, plasma), but may accept organ transplantation. The authors developed a multidisciplinary protocol for liver transplantation in Jehovah's witnesses. In a 6-year period, nine Jehovah's witness patients were listed for liver transplantation. They received preoperative erythropoietin therapy, with iron and folic acid that allowed significant haematocrit increase. Two patients underwent partial spleen embolization to increase platelet count. Seven patients underwent cadaveric whole liver transplantation, and two right lobe living-related liver transplantation, using continuous circuit cell saving system and high dose aprotinin. No patient received any blood product during the surgical procedure. One patient suffering from deep anaemia after living-related liver transplantation was transfused as required by his family, but died from aspergillus infection. One 6-year-old child was transfused against her parent's will. The authors demonstrated that it is possible to increase haematocrit and platelet levels in cirrhotic patients awaiting liver transplantation. They were able to reduce intraoperative need for blood products, allowing liver transplantation in prepared Jehovah's witness patients. This experience may be beneficial for non-Jehovah's witness liver transplant recipients. [less ▲]