Annales françaises d'anesthèsie et de rèanimation
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Ann Fr Anesth Reanim · Jan 1997
Case Reports[Peridural abscess complicating spinal anesthesia in a diabetic patient].
Infectious complications of spinal or epidural anaesthesia are rare, particularly after spinal anaesthesia. Most of them consist of a meningitis. We report a case of epidural abscess due to Staphylococcus aureus following spinal anaesthesia in a 62-year-old diabetic patient, diagnosed 45 days after the puncture with bacterial samples and magnetic resonance imaging. The pejorative neurological outcome required a laminectomy in spite of an efficient anti-staphylococcal treatment.
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Ann Fr Anesth Reanim · Jan 1997
[Anesthesia and intensive care of craniostenosis and craniofacial dysmorphism in children].
Craniosynostosis occurs in one out of 2,000 births. It results in primary skull deformations requiring surgical repair, in infants with a body weight of less than 10 kg. Pure craniosynostosis is the most frequent situation, where the risk for cerebral compression during brain development is the lowest. ⋯ With experienced teams, this high-risk surgery carries a low peroperative mortality (less than 1%) and morbidity rate. The latter includes essentially transient peroperative hypotension. The excellent final cosmetic and functional results justify the practice of this surgery in children with a bodyweight of less than 10 kg.
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Ann Fr Anesth Reanim · Jan 1997
[Decision to limit or practise maximum therapeutic support in a neurosurgical intensive care unit].
To assess the respective rates of intensive care maximalization, limitation and withdrawal practice in a neurosurgical intensive care unit. ⋯ This prospective study confirmed the results of several previous surveys. The medical decision to limit or to discontinue treatments is rather frequent in intensive care units. This is an illegal practice in French legislation and code of professional ethics. Recommendations by representative French medical associations on the modalities of decision making on limitation of therapy would be welcome.
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To describe and to assess the use of a checklist for anaesthetic equipment, the effects on the quality of care, as well as the difficulty to obtain a complete and permanent compliance of anaesthesia staff to the use of the checklist, in comparison with the practice patterns in other countries and of the recommendations by the French society of anaesthesia and intensive care for the anaesthetic machine checking. ⋯ This study demonstrated the safety benefits associated with the procedure of checking anaesthetic equipment, but also pointed out the difficulty to obtain a full participation of the staff in quality-assurance programmes.