Papers by Lionel B Dumont
European Journal of Anaesthesiology, 2015
The Swiss Agency for Development and Cooperation/ Humanitarian Aid deployed a Foreign Medical Tea... more The Swiss Agency for Development and Cooperation/ Humanitarian Aid deployed a Foreign Medical Team type 2 (http://www.who.int/hac/global_health_cluster/ fmt_guidelines_september2013.pdf) ‘Mother and Child’. The team’s primary focus is on the mother and child population, including surgery, medicine, deliveries and caesarean section. Five days after the earthquake (Wednesday 29 April 04 : 00 p.m. local time), the team, which included two anaesthetists and basic equipment and drugs for performing spinal, loco-regional and ketamine anaesthesia, arrived in the District Hospital of Gorkha.
Ann Fr Anesth Reanim, 2003
High Altitude Medicine & Biology, 2015
International journal of obstetric anesthesia, 1998
We report a case of a woman with carnitine palmityl deficiency (CPT) and idiopathic thrombocytope... more We report a case of a woman with carnitine palmityl deficiency (CPT) and idiopathic thrombocytopenic purpura, presenting in active labour at 38 weeks gestation. We discuss different anaesthetic factors involved with both diseases, and we propose an optimal management of such cases. Neuraxial analgesia with minimal motor blockade is indicated in early labour because it is necessary to alleviate stress in order to avoid rhabdomyolisis associated with CPT deficiency. Neuraxial analgesia is also needed because the theoretical risk of performing a caesarean section is higher than in a normal population, first because labour must be kept as short as possible and secondly because the possible thrombocytopenic in the baby precludes the use of instrumental delivery.
Revue médicale de la Suisse romande, 2000
Aviation, space, and environmental medicine, 1999
Acta anaesthesiologica Belgica, 1998
Peritoneal insufflation with CO2 has been associated with profound cardiorespiratory disturbances... more Peritoneal insufflation with CO2 has been associated with profound cardiorespiratory disturbances, which may modify cerebral blood flow (CBF), particularly in hypertensive patients in whom CBF autoregulation is altered. We report a case of bilateral mydriasis during laparoscopic gastrectomy in a patient with chronic hypertension followed by a coma lasting several hours and we shortly discuss the possible mechanisms involved.
Acta anaesthesiologica Belgica, 1996
Neurotoxicity of spinally administered hyperbaric 5% lidocaine is becoming a serious concern in v... more Neurotoxicity of spinally administered hyperbaric 5% lidocaine is becoming a serious concern in view of the recent literature. We report a case of probable neurotoxicity of hyperbaric 5% lidocaine, followed by an aseptic meningitis. This case report emphasizes the danger of using hyperbaric 5% lidocaine in a too high dose while performing spinal anesthesia.
Acta anaesthesiologica Belgica, 1995
Methaemoglobinemia is a rare but well known complication of the use of prilocaïne in locoregional... more Methaemoglobinemia is a rare but well known complication of the use of prilocaïne in locoregional anaesthesia. We report a case of methaemoglobinemia following the administration of a low dose of prilocaïne for an interscalenic bloc. We suggest some hypotheses to explain this phenomenon. This case illustrates the necessity of pulse oximetry monitoring in all patients receiving prilocaïne during locoregional anaesthesia.
Evidence-based Obstetric Anesthesia, 2005
Wilderness & Environmental Medicine, 2002
Travel Medicine and Infectious Disease, 2005
Two areas of controversy in altitude medicine are briefly reviewed. The first area concerns the p... more Two areas of controversy in altitude medicine are briefly reviewed. The first area concerns the prevention of acute mountain sickness (AMS) with acetazolamide. It is argued that for full prevention of AMS symptoms 500-750mg a day is necessary, but that symptom attenuation may be possible with lower doses. The second concerns the study of the relationship between cerebral blood flow and acute mountain sickness. Multiple methodological problems can be identified; some are related to the experimental settings and some to limitations of the technical tools that are used to estimate cerebral blood flow. For the moment it remains unknown whether or not a change in cerebral blood flow is an etiological factor for the development of acute mountain sickness.
Regional Anesthesia and Pain Medicine, 1999
Regional Anesthesia and Pain Medicine, 1998
During a combined spinal and epidural technique, extension of sensory block by epidural injection... more During a combined spinal and epidural technique, extension of sensory block by epidural injection of saline or bupivacaine has been demonstrated and attributed to a volume effect or to the combination of a volume effect with a local anesthetic effect. This two-part study was designed to evaluate the time dependency of the volume effect and the local anesthetic effect on the mechanism of spinal block extension. We performed two prospective studies. Thirty patients were randomized in each study. A combined spinal and epidural was performed in a sitting position in all groups. The patients in the first study received 15 mg hyperbaric bupivacaine intrathecally and were placed supine 2 minutes after spinal injection. They received 10 mL epidural saline either 5 minutes after spinal (group A) or 20 minutes after spinal (group B) compared to a control group (group C). The patients in the second study received 12.5 mg hyperbaric bupivacaine intrathecally and were placed supine 5 minutes after spinal injection. They then received epidurally either 10 mL saline 7 minutes after spinal (group D) or 10 mL bupivacaine 7 minutes after spinal (group E) or nothing (group F). Sensory block levels were assessed by a loss of sensation to cold using ether. In the first portion of this study, in group A, area under the curve of sensory block levels by time from 10 to 40 minutes after spinal injection, and maximum sensory block levels were significantly higher (P < .05) compared to groups B and C. In the second portion of the study, sensory block levels were comparable at all times in the three groups. During a combined spinal and epidural technique with the use of hyperbaric bupivacaine, the volume effect is time dependent and is seen when epidural top up is done soon after spinal injection. This volume effect is abolished when patients are left seated for 5 minutes after spinal injection. The local anesthetic effect is not demonstrated when high sensory block levels are achieved by spinal injection.
New England Journal of Medicine, 2000
Medicine & Science in Sports & Exercise, 1999
Neurological impairment, mental dysfunction, and brain imaging changes caused by severe hypoxia h... more Neurological impairment, mental dysfunction, and brain imaging changes caused by severe hypoxia have been described by several authors. However, the occurrence of transitory, long lasting, or permanent brain damage has been debated. Although climbing to 8000 m is reserved to a small number of climbers, there are hundreds of lowlanders spending relatively short holidays climbing peaks up to 6000 m in the Andes or in the Himalayas. They are usually not well acclimated and often suffer from acute mountain sickness (AMS). The aim of this study was to examine the effect of a single high altitude exposure on the changes in brain MRI and neuropsychological testing in climbers. Brain MRI, medical history, and a battery of neuropsychological tests were obtained in eight male climbers between 31 and 48 yr of age a few days before and between 5 and 10 d after returning to sea level following ascent to altitudes of over 6000 m without oxygen. The mean AMS symptom score recorded at 5500 m was three in all climbers, headache being the predominant symptom. We did not observe the changes in brain imaging and in neuropsychological testing observed by other authors. The residual central nervous system impairment following return from high altitude was not observed in our study, and the good results in neuropsychological testing were well correlated with the unchanged brain MRI imaging.
Journal of Clinical Anesthesia, 2000
cancer pain. However, in experimental animal models, the newer antiepileptic drugs seem superior ... more cancer pain. However, in experimental animal models, the newer antiepileptic drugs seem superior to the established antiepileptics. 12 Lamotrigine, felbamate, and gabapentin could reverse allodynia in the chronic constriction injury model, whereas carbamazepine and phenytoin were ineffective. 12 This case report confirms earlier findings. Lamotrigine is a valuable co-analgesic in the treatment of neuropathic cancer pain.
Journal of Cardiothoracic and Vascular Anesthesia, 2000
High Altitude Medicine & Biology, 2003
European Journal of Anaesthesiology, 2008
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Papers by Lionel B Dumont