Annales françaises d'anesthèsie et de rèanimation
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Ann Fr Anesth Reanim · Jul 2003
Randomized Controlled Trial Comparative Study Clinical Trial[Topical methylprednisolone vs lidocaïne for the prevention of postoperative sore throat].
We assessed the efficacy of topical methylprednisolone or lidocaine for prevention of postoperative sore throat. ⋯ Topical methylprednisolone may therefore be a useful adjuvant in the prevention of sore throat after intubation.
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To review the perioperative anaesthetic management of ventricular assist devices. ⋯ Cardiac transplantation is an effective treatment for patients in end stage cardiac failure, but the average waiting time of 17 months, associated with the lack of organs (357 out of 832 candidates were transplanted in 1996) results in a high number of deaths in patients awaiting transplantation. The appearance in the 1980's, of the first ventricular assist device (VAD) provided a new possibility for the management of patients with end-stage cardiac failure awaiting transplantation ("bridge to transplant"). The perioperative anaesthetic management of these patients is complex. End stage cardiac failure, poorly responsive to pharmacological interventions, results rapidly in secondary organ dysfunctions. VADs produce a rapid improvement in haemodynamic, renal, hepatic and neuro-endocrine functions over a 2 months period, allowing transplantation to take place under optimal conditions. However VADs are not without complications (1 year mortality of 20%), of which the major are: infections (40%), perioperative haemorrhage (30%) and thrombo-embolic sequelae (30%). A best knowledge of pathophysiology of these complications is necessary to an optimal management of patients with ventricular assist devices.