Annales françaises d'anesthèsie et de rèanimation
-
Ann Fr Anesth Reanim · Mar 2009
Review[Acute traumatic haemorrhagic shock and transfusion: what's new in 2009?].
In spite of continuous progress in surgery and in interventional radiology, massive haemorrhage remains a leading cause of death in traumatology. The transfusional strategy appears a key step in the treatment of haemorrhagic shock. In the light of new insights into the pathophysiology of coagulopathies associated with traumatic shock it seems reasonable to transfuse patients with haemorrhagic shock earlier than previously recommended.
-
Ann Fr Anesth Reanim · Mar 2009
Review[Effect of local anesthetics on the postoperative inflammatory response].
Current knowledge suggests that peripheral inflammation following surgery activates and sensitizes both peripheral and central nervous system. These phenomena involved in the maintenance of the inflammatory response lead to hypersensibility, hyperalgesia and allodynia. Hyperalgesia participates in the general experience of postoperative pain and ALo in the development of chronic pain. ⋯ The mechanisms involved are not clearly elucidated. Local, systemic, and spinal inflammatory mechanisms may be influenced by local anesthetics through multiple different mechanisms. The therapeutic implications of effects of local anesthetics on local, systemic, and spinal inflammatory responses merit further study.