Annales françaises d'anesthèsie et de rèanimation
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Ann Fr Anesth Reanim · Sep 2012
Case Reports[Iatrogenic gas embolism during upper gastroscopy in a patient with a multiperforated biliary drain placed by radiological way].
The authors report the first case of gas embolism arising during an upper gastrointestinal endoscopy to a patient carrier of a biliary drain placed by radiological way. The hypothesis of a biliary-vascular fistula with abnormal connection between the biliary tree and the hepatic vascular system and finally an arteriovenous intrapulmonary shunt was retained to explain the physiopathology. The immediate stop of the endoscopic procedure and the implementation of symptomatic treatment allowed a favorable neurological outcome without sequelas. The realization of an upper gastrointestinal endoscopy to a patient carrier of a biliary drain has to lead the anaesthesiologists and the gastroenterologists to take care given the incurred risk of gas embolism.
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Ann Fr Anesth Reanim · Sep 2012
Case Reports[Pulmonary embolism and intracranial hemorrhage: is there still an indication for a caval filter placement?].
The treatment of pulmonary embolism is mainly based on anticoagulants and intravenous thrombolysis in case of collapse. The cerebral hemorrhage is the main complication of thrombolysis and contraindicates anticoagulation. ⋯ The patient had persistent respiratory and hemodynamic instability related to the pursuit of embolic phenomena. The implementation of a cava filter was performed and the patient had a favorable outcome.
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Ann Fr Anesth Reanim · Sep 2012
Case Reports[Postpartum pneumomediastinum associated with subcutaneous emphysema: a case report].
This case report refers to a 21-year-old primigravida, who complained of dyspnoea and was noticed to have unusual swelling of the face and neck after home delivery. A diagnosis of subcutaneous emphysema was made and this was confirmed with the chest X-ray. Pneumomediastinum and hydropneumothorax were also detected. Uneventful recovery over three days followed conservative management.
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Ann Fr Anesth Reanim · Sep 2012
[French national survey on remifentanil utilisation for obstetrical peridural analgesia].
The last French survey on alternatives to neuraxial anaesthesia for labour pain was published in 1997. However, intravenous remifentanil has become increasingly used as an option for labour analgesia. We evaluated the use of remifentanil as an alternative to epidural analgesia in level 2 and 3 French maternities in 2009. ⋯ Intravenous administration of remifentanil was largely reported as an alternative to neuraxial anaesthesia for labour pain. Although remifentanil administration was most often based on a local written protocol, bolus dose and background infusion varied widely between maternity units.
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Ann Fr Anesth Reanim · Sep 2012
[Initial training in regional anesthesia for the French residents: a nationwide survey].
To assess both level and type of the initial training on regional anesthesia for French residents after the publication of formalized recommendations of experts on training and practice in regional anesthesia in 2006. ⋯ The main goal of the formalized recommendations on training and practice in regional anesthesia is partially reached. This apparent failure can be due to both a lack of regional anesthesia exposure, inadequate faculty training, usual slavery to routine, or technical evolution of medical practice.