Annales françaises d'anesthèsie et de rèanimation
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Ann Fr Anesth Reanim · Mar 2014
Case Reports[Difficult intubation: Should follow the recommendations.]
Intubation and ventilation impossible mask is a dramatic situation with potentially serious consequences. We report the case of a patient of 43 years, followed for a goiter, which was scheduled for a total thyroidectomy under general anesthesia. Preoperative evaluation is not noted signs of compression or tracheal deviation, and there were no criteria predictive of intubation or difficult mask ventilation. ⋯ A tracheostomy was done urgently. The patient was operated on, six months later, with a fiber optic intubation. Through this case, the authors draw attention to the difficulty of achieving an emergency tracheotomy in the presence of goiter and emphasize the need for integration of different modes of learning and retention of management skills of the upper airway.
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Ann Fr Anesth Reanim · Mar 2014
Letter Case Reports[Intraoperative cardiac arrest of a hepatic hydatid cyst surgery.]
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Ann Fr Anesth Reanim · Mar 2014
Case Reports[Hemoptysia and postoperative pulmonary edema after general anesthesia for amygdalectomy.]
Acute postoperative negative pressure pulmonary edema with hemoptysia as a complication of general anesthesia is seldom. Its is related to an obstacle on airway, with important negative intrathoracic depression during inspiration leading to pulmonary edema and hemoptysia. Physiopathology and treatment of such complication have been discussed.
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Ann Fr Anesth Reanim · Mar 2014
Comparative Study[Locating the cricothyroid membrane in learning phase: Value of ultrasonography?]
Emergency cricothyroidotomy is recommended as life-saving maneuver when mask ventilation and tracheal intubation are impossible. It requires the puncture of the cricothyroid membrane (CTM) whose clinical identification is difficult. The objective of this study is to evaluate if ultrasound can help locating the CTM by comparing palpation and ultrasonographic evaluation. ⋯ Following a limited training phase, ultrasound allowed a more effective localization of CTM by residents when compared to clinical palpation in overweight patients. This benefit remained significant when assessment was repeated 6 months later.
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Ann Fr Anesth Reanim · Mar 2014
Comparative Study[Epidemiology of the medico-legal risk associated with the practice of ambulatory surgery in France: A study based on insurance data.]
The medico-legal risk specifically associated with the practice of ambulatory surgery is still not well studied. SHAM insurances are the biggest French provider of medical liability insurances. The study of the insurance claims provided by this insurer is therefore a relevant source of data on the complications related to ambulatory surgery. ⋯ The claim rate in ambulatory surgery is proportionally less frequent with compensations three times less and were related to the most frequent type of surgery done in ambulatory settings. These data should help strengthen quality approach in ambulatory surgery.