Annales françaises d'anesthèsie et de rèanimation
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Ann Fr Anesth Reanim · Jan 1998
Review[The sitting position in neurosurgery: the viewpoint of the anesthetist].
The sitting position can be used safely in neurosurgery, if meticulous attention is given to the positioning and the monitoring of the patient during surgery. Venous air embolism remains the most frequent complication. Hypotension is the second complication. A rigorous patient selection of patients, the experience of the anesthesiologist and the neurosurgeon remain the main factors for the choice of the sitting position.
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We analysed the data on the risk of infection during practice of locoregional anaesthesia (LRA) and propose recommendations for its prevention. The epidemiologic data show that the incidence is very low. ⋯ The benefit-risk ratio must be considered, specifically in obstetrics. Precautions which must be followed during the practice of LRA are discussed.
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Ann Fr Anesth Reanim · Jan 1998
Comparative Study Clinical Trial[Continuous analgesia with a femoral catheter: plexus or femoral block?].
To evaluate the spread and quality of sensitive blockade produced by continuous and prolonged use of a femoral catheter inserted for postoperative analgesia. ⋯ In most patients, a local anaesthetic administered continuously via a femoral catheter produces a blockade limited to the femoral nerve. These data do not substantiate the conclusions by those who consider they are producing a continuous "3 in 1" block with this technique. However, it is obviously not essential to produce a sensitive blockade of the three main nerves of the lumbar plexus to obtain an effective analgesia after knee surgery.
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Ann Fr Anesth Reanim · Jan 1998
Comparative Study[Principles of tests of hypotheses in statistics: alpha, beta and P].
Modern clinical research requires control of statistical methods. We reviewed 120 original manuscripts which were submitted to the Annales françaises d'anesthésie et de reanimation and analyzed their statistical methodology. Most of them contained errors (inappropriate numerical expression of the data, uncontrolled alpha risk, lack of power, use of inadequate statistical tests) and only 9 (7%) were considered as adequate. ⋯ The following items should be checked to choose the appropriate test: assess the kind of variable, verify the requirements for application of the test (type of the variable distribution, sample size, particular conditions such as equality of variance, dependence or independence of the variables), determine if data come from paired samples or if multiple comparisons are performed. Statistical analysis has become more easy with computers, however a precise knowledge of statistics remains essential. Advice from a statistician is often useful especially when obtained a priori and not a posteriori.
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To evaluate the incidence and the causes of early intra- and postoperative deaths in a multidisciplinary hospital. ⋯ In this survey, mortality due to anaesthesia was higher than the rates reported in other studies. Human error remained the main cause.