Annales françaises d'anesthèsie et de rèanimation
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Ann Fr Anesth Reanim · Sep 2011
Clinical Trial[Ultrasound control of local anaesthetic location after TAP block performed using landmark-based technique: a cohort study].
TAP is a regional anaesthetic technique where local anaesthesic (LA) is injected between the internal oblique and the transversus abdominis muscles in order to block intercostal nerves. The technique originally described, is based on the identification of the lumbar triangle of Petit as the area where to insert the needle before the LA injection. We performed a study to determine, using ultrasonography, the actual location of the LA when TAP block was performed using landmark-based technique. ⋯ The localization of LA after the TAP block being performed by landmark-based techniques is highly variable. In the majority of patients, the LA was injected in adjacent anatomical structures with unpredictable block results. This may promote the use of ultrasound-guided technique to perform the TAP block.
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Ann Fr Anesth Reanim · Sep 2011
Case Reports[Anaesthesia for caesarean section in a pregnant woman with cor triatriatum].
A 41-year-old woman suffering from a left cor triatrium, pregnant for the first time, was hospitalized for a caesarean section in the context of a pulmonary arterial hypertension with severe anaemia. The anaesthetic strategy which was decided on involved setting up a haemodynamic monitoring prior to induction of a general anaesthetia with etomidate, remifentanil and succinylcholine and maintained with propofol, sufentanil and cisatracurium. ⋯ The improvement of the arterial pulmonary hypertension immediately after coming out of the operating theatre allowed the patient to be briefly monitored in the intensive care unit and to be allowed home on the 10th day following the operation. The patient's cardiopathy was corrected in the 5th month after the birth.
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Ann Fr Anesth Reanim · Sep 2011
[Assessment of withholding life support and withdrawing life support in a vital emergency department].
To evaluate the practices of withholding and withdrawing of life sustaining therapies in a vital emergencies department and to confront them with Leonetti law procedures. ⋯ The application of Leonetti law in vital emergencies department is flawed. It appears to be necessary to realize new studies and to release official guidelines or recommendations specifically made for emergencies department to improve the practices of withholding or withdrawing life sustaining treatments.
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Ann Fr Anesth Reanim · Sep 2011
[Management of hypotension during spinal anaesthesia for elective caesarean section: a survey of practice in Lorraine region].
The aim of the survey was to describe current practice in management of hypotension during spinal anaesthesia for elective caesarean section in Lorraine. ⋯ Management of hypotension during spinal anaesthesia for elective caesarean section was significantly influenced by the type of practice.
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Ann Fr Anesth Reanim · Sep 2011
Case Reports[A parotitis as primary infection of Lemierre's syndrome].
Lemierre's syndrome is a classical presentation of human necrobacillosis. It is characterized by a primary infection in the face including a septic thrombophlebitis of the internal jugular vein and disseminated metastatic abcesses. ⋯ Most of the time a well-chosen antibiotic treatment against anaerobic pathogens and Gram negative bacilli is efficient but surgery can be useful. We report a case of a 73 years old man, which seems to be unique because it is the first case reported of a Lemierre's syndrome characterized by a parotitis infected by F. necrophorum.