Annales françaises d'anesthèsie et de rèanimation
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Ann Fr Anesth Reanim · Jan 2012
[Epidural analgesia for surgical treatment of peritoneal carcinomatosis: a risky technique?].
To study the risks of haemodynamic instability, and the possible occurrence of spinal haematoma, meningitis and epidural abscess when epidural analgesia is performed for cytoreductive surgery and hyperthermic intraperitoneal chemotherapy (HIPEC). ⋯ In this series of 35 patients, the use of epidural analgesia for HIPEC does not seem to be associated with a worse risk of haemodynamic instability, spinal haematoma, meningitis or epidural abscess. HIPEC with platinum salt is not incompatible with the safety of epidural analgesia, with an optimized fluid management peroperatively and the following of perimedullary anesthesia practice guidelines.
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Ann Fr Anesth Reanim · Jan 2012
[Second wave of the French drug harmonisation programme to prevent medication errors: overall appreciation of healthcare professionals].
Medication errors are a significant cause of severe healthcare-associated complications. In December 2006, the French Health Products Agency (Afssaps) has issued a protocol to harmonise labeling of injectable drugs vials. In 2007, a first change was launched for four drugs and was followed in 2008-2009 by a second wave concerning 42 active drugs. ⋯ This national survey describing the perception of healthcare professionals regarding the new harmonisation procedure for injectable drugs highlighted some progress but also a number of deficiencies, notably regarding communication and implementation of the change in clinical units. This survey will be used by the French Health Products Agency to improve future steps of the long-lasting campaign against medication errors.
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Ann Fr Anesth Reanim · Jan 2012
Case Reports[Dissection of the descending aorta complicated by preeclampsia at 30 weeks of gestation: medical treatment and caesarean delivery].
The authors report the case of a dissection of the descending thoracic aorta in a woman in the third trimester of the pregnancy. After an initial medical therapy by a combination of three intravenous anti-hypertensive medications, a caesarean section was decided under general anaesthesia at 30 weeks of gestation as the result of the occurrence of a severe preeclampsia. The aetiology, diagnosis, and anaesthetic management are discussed.
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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.
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Ann Fr Anesth Reanim · Jan 2012
[Caudal block and light sevoflurane mask anesthesia in high-risk infants: an audit of 98 cases].
In order to reduce the risk of postoperative apnoea, awake spinal anaesthesia or awake caudal anaesthesia are recommended for hernia surgery in newborn babies and former premature infants aged less than 60 weeks of amenorrhoea. However, additional sedation is sometimes necessary. Our working hypothesis was that a general anaesthesia with a face mask (sevoflurane) with no opiates nor neuromuscular blocking agents, maintaining the infant's spontaneous breathing and combined with a caudal anaesthesia, could provide a safe and effective alternative. ⋯ The technique proposed is an effective alternative to the awake locoregional anaesthesia techniques: it provides excellent conditions for surgery and presents similar perioperative morbidity and risk of postoperative apnoea.