Acta anaesthesiologica Belgica
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Acta Anaesthesiol Belg · Jan 2013
ReviewShould the "in situ" simulation become the new way in Belgium? Experience of an academic hospital.
The place of simulation in medical education, particularly in anesthesia, appears to be more and more evident. However, the history of simulation in Belgium showed that the associated costs remain a barrier. The use of 'in situ' simulation, defined as the practice of simulation in the usual workplace, could solve the problem of providing access to this educational tool. ⋯ This allows developing skills related to teamwork and communication. Despite those numerous advantages, several difficulties persist. The associated logistic and organizational constraints can be cumbersome.
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Acta Anaesthesiol Belg · Jan 2013
ReviewUnplanned cesarean section in parturients with an epidural catheter in-situ: how to obtain surgical anesthesia?
Epidural analgesia is frequently used for labor. Several authors advocate its use when parturient women are at increased risk for emergency Cesarean delivery. Hereby, the time needed to achieve adequate surgical anesthesia may be shortened and general anesthesia may be avoided. ⋯ Little consensus can be found in literature about the nature of local anesthetic solution to be used to provide rapid onset and high quality anesthesia for the entire duration of surgery. Women, whose epidural analgesia extension fails either receive a new neuraxial blockade, or receive general anesthesia. We reviewed the medical literature to better define the best methods and choice of products at providing a rapid and adequate surgical anesthesia in parturient women with an epidural catheter in-situ.
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Acta Anaesthesiol Belg · Jan 2013
Randomized Controlled TrialCombination of remifentanil with isoflurane or propofol: effect on the surgical stress response.
Hormonal and metabolic changes following surgery are markers of the stress response to surgery. We compared hemodynamic parameters and stress response markers (glucose, cortisol, and C-reactive protein) in two groups of patients receiving either propofol or isoflurane combined with remifentanil for maintenance of anesthesia. ⋯ An anesthetic regimen combining propofol and remifentanil attenuates two indicators of the stress response more efficiently than a isoflurane - remifentanil combination.
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Acta Anaesthesiol Belg · Jan 2013
Randomized Controlled Trial Comparative StudyComparison of tube-taping versus a tube-holding device for securing endotracheal tubes in adults undergoing surgery in prone position.
Endotracheal tube displacement is one of the leading causes for airway related complications. Endotracheal tube displacement is much more common in the prone position than in the supine position. ⋯ Both methods of fixation of the endotracheal tube are clinically useful in the prone position but the Thomas tube holder is more effective than adhesive tape in preventing displacement of endotracheal tube.