Cahiers d'anesthésiologie
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Cahiers d'anesthésiologie · Jan 1991
Case Reports[Formation of a knot in a J spiral metallic guide: a complication of the Seldinger method].
Central venous catheter insertion by Seldinger's technique uses a wire guide which could be cause of complications. This case reports a blocked wire guide of which J tip was responsible for knotting. Utilization of vessel dilator of central venous catheterization set (Arrow) permitted to liberate and withdraw the wire guide without surgical operation. A larger use of this wire guide could increase the frequency of such complications.
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Cahiers d'anesthésiologie · Jan 1991
[Complications of local and regional anesthesia. An analysis of closed files of insurance companies].
We report a review of closed insurance claims for local and regional anaesthesia mishaps in the main private professional insurance companies. Twenty eight cases with extensive written documentation were discovered, spanning a 6 years interval between 1983 and 1989, involving 21 epidural, 6 spinal and 1 caudal anaesthesias, half with surgical and half obstetrical indication, and excluding all other blocks. Twenty four out of the 28 patients were relatively healthy. ⋯ Twenty two had a poor outcome: 8 deaths, 7 severe neurological injuries, a baby was dead and another child had severe neurobehavioral sequellae. The author points out the limitation of this study--a biased sample of all adverse events and inability to derive an incidence. However some of these events reveal patterns of anaesthetic management which lead to poor outcomes.
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A specialized unit in outpatient anaesthesia and surgery needs an adapted planning. During the preoperative period, it is particularly important to preserve the time of the patients. Different types of structures are possible for the intraoperative period depending on their degree of independence to a hospital. ⋯ During the postoperative period, a special medical organization must be planned to help the patient if necessary. The part of the secretarial work is important for the success of such a unit. Its efficiency may be improved by computerised treatment of part of the information.
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Cahiers d'anesthésiologie · Jan 1991
Editorial Comparative Study[The future of anesthesiology in France and trade unionism].