Dakar médical
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The goal of this prospective work is to study the per- and post-operative complications of spinal anaesthesia for cesarean and to evaluate their management. We included in the study all parturients undergoing cesarean section to the maternity of hospital Aristide Le Dantec since December 1998 to March 1999. Patients presented contra-indications of spinal anaesthesia, arterial hypertension and/or acute fetal distress were excluded. ⋯ Maternal hypotension was the only per-operative complication in our study: 52% with 2 cases of cardiac arrest who needed tracheal intubation and injection of epinephrine. Post operative complications were represented by post-dural headaches about 5.4% and no epidural blood-patch were necessary for their management. We have noted any neurological or infectious complication during supervision of our patients.
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Foreign body inhalation is a serious emergency which raises both diagnostic and therapeutic problems. Progress achieved in the domain of instrumentation and anaesthesia permit the endoscopic extraction with incontestable comfort and security However, child's anaesthesia often in respiratory distress can prove to be difficult. The aim of this study was to evaluate problems encountered during anaesthesia for endoscopic extraction of foreign bodies in lower respiratory tract and to submit an adequate management strategy. ⋯ All endoscopic procedures have been achieved under general anaesthesia with intubation by the bronchoscope. Three patients presented peroperative cardiopulmonary arrest and 8 patients died after endoscopy. The improvement of technical means will permit to reduce morbidity and mortality linked to foreign body inhalation.
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The diagnosis and the management of the foreign bodies of the oesophagus in the children have benefited from the digestive endoscopy and the anaesthesia progresses the last ten years. A 120 files review concerning children who suffered from foreign bodies of the oesophagus is reported. The average age was 4 years. ⋯ The foreign body of the oesophagus is not always harmless. It can determine complications often revealing ones. It seems necessary to us to stress the prevention of that accident by a vast sensitising compaign of the parents.