Annales françaises d'anesthèsie et de rèanimation
-
Ann Fr Anesth Reanim · Dec 2003
Case Reports[Continuous lumbar plexus block sets in France. Our experience].
The undeniable postoperative analgesia brought by the lumbar plexus block among patients scheduled for major surgery of the hip or knee justifies, the setting of a catheter to allow a continues analgesia more durable. Having drawn aside the difficulties of the daily practice (in allusion to the number of blocks carried out per day) and anatomical variations, the failure of the perineural catheter setting is in direct relationship with the material used by the anaesthesiologists for neurostimulation. The presentation of a case report describes a failure of catheter introduction due to the canula in deep continuous blocks, and the advantages and disadvantages of the various sets of neurostimulation. The authors conclude that the sets with the "catheter through the needle" are to be recommended, particularly the stimulating Tuohy needle.
-
The use of epidural analgesia and anaesthesia is controversial in patients with multiple sclerosis (MS) due to the potential neurotoxicity of local anaesthetics. The aim of this study was to evaluate the place and the safety of epidural obstetrical analgesia in these patients. ⋯ The results confirm that epidural analgesia is innocuous in this context. The important points are the precise evaluation of the existing neurological symptoms and the sparing of local anaesthetics thanks to the addition of opioids.
-
Ann Fr Anesth Reanim · Dec 2003
Case Reports[Pulmonary embolism to the rescue in cardiac tamponade].
The association of cardiac tamponade and pulmonary embolism has not previously been described. We report the case of a patient, who presented with such an association, due to an underlying pulmonary carcinoma. When a major pericardial effusion is associated with pulmonary hypertension, some echocardiographic signs of tamponade may appear, such as a moderate right ventricular collapse, or the absence of a paradoxical septum. The presence of pulmonary hypertension in this context of tamponade may have paradoxically saved the life of this patient.
-
To analyse the results of delayed evaluation of European teaching sessions using a questionnaire provided by the French College of Anaesthesiologists. ⋯ 3-6 months following the FEEA courses the participants thought to have fulfil their objectives and declared to have modify their medical practise. The lack of discussion with a manager should be analysed.