Annales françaises d'anesthèsie et de rèanimation
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Ann Fr Anesth Reanim · Jan 2012
Review[Neurological consequences after long-term sedation in the ICU].
Experiments performed in mammals, including non-human primates, have demonstrated an increase in neuronal death rates normally seen in normal brain development. Such an increase is encountered in diseases but also after exposure of the brain to various class of anaesthetics. In living animals, it can (but not always) result in persistent cognitive impairment. ⋯ Second, it is known for years than anaesthesia before 1 year of age is much riskier than after 1 year, whatever the theorical neurotoxicity is. Third, this enforces the need to develop tools enhancing the precision of anaesthesia as much as possible. Meanwhile, when an infant has undergone numerous general anaesthesias, we strongly recommend a long-time neurological follow-up.
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Ann Fr Anesth Reanim · Jan 2012
Review[Out-of-hospital management of elderly patients for trauma injury].
Elderly patients should benefit from maximum care in cases of serious trauma, starting with pre-hospital care. A proper evaluation of the gravity of the trauma is an essential element in the management. The elderly are at risk of "under-triage", which can result in inappropriate hospital admission and delayed trauma care. ⋯ Locoregional anaesthesia should be used when possible in this setting, in particular the ilio-facial block. Age is not a criterion for a non-resuscitation order in trauma patients. The decisions of limitation of therapeutic, if they were not anticipated, will be discussed after admission, according to the principles of the current legislation.
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Ann Fr Anesth Reanim · Jan 2012
Review[Pharmaco-economic aspects of perioperative pain management].
We present a reflection on pharmaco-economy of perioperative pain management. A real optimisation of expenses could be obtained if taking into consideration factors that augment and diminish costs of the process, due to the organisation of the process itself, due to optimisation of the information and decision's circuits. The cost of an analgesic is not significant when compared with the cost of entire process of pain management.
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Ann Fr Anesth Reanim · Jan 2012
[Stability and compatibility of acetaminophen, ketoprofen and amoxicillin in a fail-safe intravenous administration set].
Intravenous infusion takes an important place in the current therapy in hospitals and pharmaceutical firms keep improving their infusion medical devices, particularly with the development of an intravenous administration set with an automatic infusion stop. The aim of our study consists in an evaluation of the stability of acetaminophen, ketoprofen and amoxicillin during infusion and stasis of drugs for several hours in the dropper chamber and in the tube of this device. ⋯ Despite the technical innovation of a fail-safe intravenous administration set, we have to stay aware of mixture consequences in intravenous infusion field.
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Ann Fr Anesth Reanim · Jan 2012
Case Reports[Oesophago-gastro-duodenoscopy in a teenager and esophageal achalasia].
Oesophago-gastro-duodenoscopy for diagnostic is daily performed in adults and in children during sedation with propofol. This is administrated in France by anaesthesiologists. ⋯ The assessment has revealed an oesophageal achalasia, a condition rare in children and atypical development. This case highlights the importance of systematic screening for risk of a full stomach during the anaesthesia consultation, and the difficulty in evaluation in case of medical migrant patient.