Annales françaises d'anesthèsie et de rèanimation
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Ann Fr Anesth Reanim · Jun 1999
[Anesthesia practice by nurse anesthetists in French speaking Sub-Saharan Africa].
To evaluate the practice of anaesthesia in French-speaking subsaharian countries. ⋯ In this study, 50% of nurse anaesthetists were working alone. However, this rate is probably under-estimated, as the questionnaire did not consider anaesthesia practice in the country side.
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Ann Fr Anesth Reanim · Jun 1999
Randomized Controlled Trial Clinical Trial[Practice of spinal anesthesia in a developing country: usefulness of vascular preloading with a 7.5% hypertonic saline solution].
To assess the efficacy of hypertonic saline for prevention of arterial hypotension in patients undergoing spinal anaesthesia in Niger. ⋯ Hypertonic saline prevents efficiently the occurrence of hypotension during spinal anaesthesia. Considering its ease of preparation, the lack of adverse effects, in patients not suffering arterial hypertension or congestive heart failure, and low cost, hypertonic saline is well adapted for use in a developing country, if isotonic solutions are not available.
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This descriptive and prospective study, carried out during a 6-month period at Yaounde (Cameroon), assessed work practices relating to anaesthesia in public and private health care institutions, the incidence and causes of complications, and considers possible means for improving security of the anaesthetized patient. This study included 1,103 patients, aged 12 days to 89 years. Main surgical indications were gynaecology-obstetrics (33.3% of cases) and emergency surgery (28.6% of cases). ⋯ The rate of complications, 476 in 321 patients (29.1% of cases), was similar to the incidence registered in 1977 (30%). Twenty-four deaths occurred (overall mortality rate of 2.2%). Besides the shortage of equipment, this study underlines the necessity for producing and adhering to guidelines for safe practice of anaesthesia, adapted for developing countries.
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Ann Fr Anesth Reanim · Jun 1999
[Delivery of desflurane by a Tec 6 vaporizer at a concentration superior to that posted on the regulating valve].
We report the case of a defective Tec 6 vaporizer (Datex-Ohmeda) which delivered higher concentrations of desflurane (end-tidal concentration: 3.5 vol%) than indicated by the vaporizer dial setting (2 vol%), at a fresh gas flow of 1 L.min-1. This condition was caused by a defective rotary control valve. Therefore it is essential to administer desflurane only in presence of a vapour analyser.