Annales françaises d'anesthèsie et de rèanimation
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To describe the new procedures applied for interventional radiology leading to specific anaesthetic care and organization. ⋯ As advances in interventional radiology are obvious, general organisation as well as anaesthetic procedures should be adapted to these specific techniques.
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Obstetric anaesthesia is a "young" discipline, with constant novelties from a clinical, scientific and academic standpoint. While there is still no official sub-specialty in obstetric anesthesia, this field has become more diversified because of the growing maternal request for labor analgesia, a constant and perhaps even increasing rate of caesarean deliveries of 20-30% depending on institutions and countries, and also due to the raise in "high risk" pregnancies in women carrying various medical conditions such as complex congenital cardiopathies. In their anesthesia training, most residents rotate in the delivery room for three months on average, which should allow them to acquire good practical skills when performing regional analgesia and anesthesia for labor and delivery. ⋯ It should be recommended to develop training programs to improve the technical skills for intubation in pregnant women, which is why anaesthesia simulators may have an important role in the future. In terms of the theoretical knowledge, good academic training programs are required. The physiology of pregnancy and the physiopathology of pregnancy-related disorders justify a thorough and rigorous teaching in order to reduce both maternal and neonatal morbidity and mortality.
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Ann Fr Anesth Reanim · Jun 2006
Randomized Controlled Trial Comparative Study[Maternal postures and epidural analgesia during labour].
The evolution of birth is of interest for obstetricians and midwives. Postures with asymmetric stretching and balance, kneeling, or sitting have been claimed to be able to help foetal head rotation. Although walking during labour have no influence on the outcome of labour, hip-flexed postures enlarging the pelvic diameter are yet evaluated to improve the obstetric course of labour. ⋯ There were no differences between groups for the left and right total spread and upper level of epidural blockade, for the time to maximal block and pain relief. There was no motor block and no maternal or foetal side effects. We conclude that, for the three hip-flexed postures tested, position does not influence local anesthetic spread or symmetry of analgesia after induction of obstetric epidural anaesthesia.
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Ann Fr Anesth Reanim · Jun 2006
Review[Meticillin-resistant Staphylococcus aureus: incidence, risk factors and interest of systematic screening for colonization in intensive-care unit].
To summarize recent international and national epidemiological data of methicillin-resistant Staphylococcus aureus (MRSA) colonization in ICU. ⋯ Systematic screening for colonization on ICU admission and during hospitalization is essential for many authors to control the spread of MRSA. Other policies such as implementation of isolation precaution and antibiotic use also contribute to decrease the MRSA incidence rate observed for several years in French ICU.