Annales françaises d'anesthèsie et de rèanimation
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Ann Fr Anesth Reanim · Oct 2011
Review[Postoperative cognitive dysfunction (POCD): strategy of prevention, assessment and management].
The femoral neck fracture is a major cause of morbidity and mortality in the elderly. The etiology of cognitive impairment observed in this population of aged patient seems to be multifactorial. In the strategy of prevention, elderly patient must have the clearer information dealing with the postoperative cognitive dysfunction. ⋯ During the anaesthesia consultation, it seems important to assess the cognitive function of this elderly patient (like using neuropsycholgical scale as the MMSE) and to identify associated risk factors of cognitive dysfunction. The management of cognitive disorders should be multidisciplinary, the anesthesiologist being the main referent, in collaboration with the geriatrician and the surgeon. In the clinical setting of femoral neck fracture in the elderly, this multimodal management (pain, nutrition, functional rehabilitation to make these patients autonomous as quickly as possible), seems to improve the functional prognosis and to have the observed POCD decreased.
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Ann Fr Anesth Reanim · Oct 2011
Review[Strategy of postoperative rehabilitation after femoral neck fracture in elderly patients].
The femoral neck fracture in elderly patient is an entity that is within the scope of "disease causing a femoral neck fracture". The specific factors for successful management of these elderly patients are centered around patient's comorbidities, specific management in a clinical pathway, and more or less early rehabilitation after surgery. ⋯ The improvement of nutritional status, equilibrium for comorbidities and early rehabilitation with walking activities and physiotherapy significantly improve functional outcome at short and medium terms and postoperative mortality. The use of multimodal analgesia and regional analgesia primarily by perioperative continuous femoral nerve blocks also improve the medical prognosis and functional outcome of the patient.
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Ann Fr Anesth Reanim · Oct 2011
[Survey on anaesthetic practices for electroconvulsivotherapy in French university hospitals].
To evaluate the anaesthetic management of electroconvulsive therapy (ECT) in French university hospitals. ⋯ The recommendations remain valid while old and may be updated. They are not always followed by the teams. Continuing medical education should be promoted to a better understanding of the factors interfering between anesthesia and ECT.
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Ann Fr Anesth Reanim · Oct 2011
Editorial Case Reports[Do we know all indications and side effects of sugammadex?].